Elsherbiny Ahmed, Mazeed Ahmed S
Cleft and Craniofacial Unit, Plastic Surgery Department, Sohag University Hospital, 82524 Sohag, Egypt.
J Craniomaxillofac Surg. 2017 Jun;45(6):1010-1017. doi: 10.1016/j.jcms.2017.03.008. Epub 2017 Mar 27.
Due to the lack of a universally accepted classification system, we are aiming to introduce a modified comprehensive, precise and relatively simple classification system for primary diagnosis of cleft lip and palate.
The proposed classification is based on the Kernahan's striped Y diagram with more details in cleft extent and with the addition of severity scores to each cleft component. Clear definitions of cleft extents and severity degrees were described based on 400 consecutive primary cases. Two medical students were taught the classification then diagnosed photographs of 100 cases twice to test its reliability.
The students' results were 11% and 13% wrong diagnoses for student 1 and 2 in the first time, 8% and 10% in the second time, respectively. The inter-rater reliability for the two students in the first and second time was 0.716 and 0.878, respectively. The intra-rater reliability for student 1 and 2 were 0.826 and 0.755 respectively. The average duration to diagnose a case was less than a minute.
This classification is comprehensive and records many diagnostic variables with high reliability and precision.
由于缺乏普遍接受的分类系统，我们旨在引入一种经过改良的、全面、精确且相对简单的唇腭裂初步诊断分类系统。
所提议的分类基于克纳汉的条纹Y形图，在腭裂范围方面有更多细节，并为每个腭裂组成部分添加了严重程度评分。基于400例连续的初诊病例描述了腭裂范围和严重程度的明确定义。两名医学生学习了该分类方法，然后对100例病例的照片进行了两次诊断以测试其可靠性。
学生1在第一次诊断时的错误诊断率为11%，第二次为8%；学生2在第一次诊断时的错误诊断率为13%，第二次为10%。两名学生在第一次和第二次诊断时的评分者间信度分别为0.716和0.878。学生1和学生2的评分者内信度分别为0.826和0.755。诊断一个病例的平均时长不到一分钟。
该分类全面，能以高可靠性和精确性记录许多诊断变量。
