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Reliable classification of facial phenotypic variation in craniofacial microsomia: a comparison of physical exam and photographs.

Birgfeld CB, Heike CL, Saltzman BS, Leroux BG, Evans KN, Luquetti DV - Head Face Med (2016)

Bottom Line: The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis.Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less).The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features.

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.

ABSTRACT

Background: Craniofacial microsomia is a common congenital condition for which children receive longitudinal, multidisciplinary team care. However, little is known about the etiology of craniofacial microsomia and few outcome studies have been published. In order to facilitate large, multicenter studies in craniofacial microsomia, we assessed the reliability of phenotypic classification based on photographs by comparison with direct physical examination.

Methods: Thirty-nine children with craniofacial microsomia underwent a physical examination and photographs according to a standardized protocol. Three clinicians completed ratings during the physical examination and, at least a month later, using respective photographs for each participant. We used descriptive statistics for participant characteristics and intraclass correlation coefficients (ICCs) to assess reliability.

Results: The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis. The ICC estimates were higher than 0.6 for most features. Features with the highest ICC included: presence of epibulbar dermoids, ear abnormalities, and colobomas (ICC 0.85, 0.81, and 0.80, respectively). Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less). There was not a strong tendency for either type of rating, physical exam or photograph, to be more likely to designate a feature as abnormal. The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features.

Conclusions: Our results suggest that categorization of facial phenotype in children with CFM based on photographs is reliable relative to physical examination for most facial features.

No MeSH data available.


Related in: MedlinePlus

Photographic protocol for individuals with CFM. An example of a study visit contact sheet generated following the previously published protocol [16]
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Fig1: Photographic protocol for individuals with CFM. An example of a study visit contact sheet generated following the previously published protocol [16]

Mentions: We enrolled children ages 0–21 years who met the research eligibility criteria previously established by the Facial Asymmetry for Interdisciplinary Assessment and Learning (FACIAL) network (Table 1) and were consecutively evaluated in 2014 at a single tertiary care craniofacial center. Study procedures included an interview to collect demographic and clinical history, 16 standardized photos [16] (Fig. 1) and in-person facial exam.Table 1


Reliable classification of facial phenotypic variation in craniofacial microsomia: a comparison of physical exam and photographs.

Birgfeld CB, Heike CL, Saltzman BS, Leroux BG, Evans KN, Luquetti DV - Head Face Med (2016)

Photographic protocol for individuals with CFM. An example of a study visit contact sheet generated following the previously published protocol [16]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4815065&req=5

Fig1: Photographic protocol for individuals with CFM. An example of a study visit contact sheet generated following the previously published protocol [16]
Mentions: We enrolled children ages 0–21 years who met the research eligibility criteria previously established by the Facial Asymmetry for Interdisciplinary Assessment and Learning (FACIAL) network (Table 1) and were consecutively evaluated in 2014 at a single tertiary care craniofacial center. Study procedures included an interview to collect demographic and clinical history, 16 standardized photos [16] (Fig. 1) and in-person facial exam.Table 1

Bottom Line: The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis.Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less).The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features.

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.

ABSTRACT

Background: Craniofacial microsomia is a common congenital condition for which children receive longitudinal, multidisciplinary team care. However, little is known about the etiology of craniofacial microsomia and few outcome studies have been published. In order to facilitate large, multicenter studies in craniofacial microsomia, we assessed the reliability of phenotypic classification based on photographs by comparison with direct physical examination.

Methods: Thirty-nine children with craniofacial microsomia underwent a physical examination and photographs according to a standardized protocol. Three clinicians completed ratings during the physical examination and, at least a month later, using respective photographs for each participant. We used descriptive statistics for participant characteristics and intraclass correlation coefficients (ICCs) to assess reliability.

Results: The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis. The ICC estimates were higher than 0.6 for most features. Features with the highest ICC included: presence of epibulbar dermoids, ear abnormalities, and colobomas (ICC 0.85, 0.81, and 0.80, respectively). Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less). There was not a strong tendency for either type of rating, physical exam or photograph, to be more likely to designate a feature as abnormal. The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features.

Conclusions: Our results suggest that categorization of facial phenotype in children with CFM based on photographs is reliable relative to physical examination for most facial features.

No MeSH data available.


Related in: MedlinePlus