Campbell Alex, Restrepo Carolina, Deshpande Gaurav, Tredway Caroline, Bernstein Sarah M, Patzer Rachel, Wendby Lisa, Schonmeyr Bjorn
Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden.
Plast Reconstr Surg Glob Open. 2017 Sep 13;5(9):e1472. doi: 10.1097/GOX.0000000000001472. eCollection 2017 Sep.
A standardized evaluation tool is needed for the assessment of surgical outcomes in cleft lip surgery. Current scales for evaluating unilateral cleft lip/nose (UCL/N) aesthetic outcomes are limited in their reliability, ease of use, and application. The Unilateral Cleft Lip Surgical Outcomes Evaluation (UCL SOE) scale measures symmetry of 4 components and sums these for a total score. The purpose of this study was to validate the SOE as a reliable tool for use by both surgeons and laypersons.
Twenty participants (9 surgeons and 12 laypeople) used the SOE to evaluate 25 sets of randomly selected presurgical and postsurgical standardized photographs of UCL/N patients. Interrater reliability for surgeon and laypeople was determined using an intraclass correlation coefficient (ICC).
Individual surgeons and laypeople both reached an ICC in the "fair to good" range (ICC = 0.42 and 0.59, respectively). Averaging 2 evaluators in the surgeon group improved the ICC to 0.58 and in the laypeople group to 0.74, respectively. Averaging 3 evaluators increased the ICC for surgeons to the "good" range (ICC = 0.71) and the ICC for laypeople to the "very good" range (ICC = 0.82).
Surgeon and layperson raters can reliably use the SOE to assess the aesthetics results after surgical repair of UCL/N, and improved reliability and reproducibility is achieved by averaging the scores of multiple reviewers.
唇裂手术的手术效果评估需要一种标准化的评估工具。目前用于评估单侧唇裂/鼻（UCL/N）美学效果的量表在可靠性、易用性和适用性方面存在局限性。单侧唇裂手术效果评估（UCL SOE）量表测量4个组成部分的对称性，并将这些得分相加得出总分。本研究的目的是验证SOE作为一种可靠的工具，供外科医生和非专业人员使用。
20名参与者（9名外科医生和12名非专业人员）使用SOE评估25组随机选择的UCL/N患者术前和术后的标准化照片。使用组内相关系数（ICC）确定外科医生和非专业人员之间的评分者间信度。
个体外科医生和非专业人员的ICC均达到“中等至良好”范围（分别为ICC = 0.42和0.59）。外科医生组平均2名评估者，ICC分别提高到0.58，非专业人员组提高到0.74。平均3名评估者，外科医生的ICC提高到“良好”范围（ICC = 0.71），非专业人员的ICC提高到“非常好”范围（ICC = 0.82）。
外科医生和非专业评分者均可可靠地使用SOE评估UCL/N手术修复后的美学效果，通过对多个评分者的分数进行平均可提高信度和可重复性。
