Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.
J Craniofac Surg. 2020 Sep;31(6):1613-1619. doi: 10.1097/SCS.0000000000006524.
Uncertain clinical evidence for treating positional plagiocephaly, especially with helmet therapy, creates difficulties in counseling parents of patients. This study investigates layperson perceptions and treatment preferences for positional plagiocephaly to provide patient-oriented evidence for management.
Adult laypersons were recruited through crowdsourcing to view digitally-modified images of normal, mildly, moderately, or severely plagiocephalic infant heads. Participants provided demographic information and rated the infant's head shape and potential related social difficulties, likelihood of consulting a physician for treatment options, and likelihood of seeking helmeting treatment for the infant.
Nine hundred forty-five individuals participated in the study. Perception of head shape, prediction of future embarrassment and social difficulties, likelihood of seeking physician evaluation, likelihood of choosing helmet therapy, and willingness-to-pay for helmet therapy were pairwise-different between 4 plagiocephaly severities (corrected-P < 0.001 for all), except between normocephaly (n = 194) and mild (n = 334) plagiocephaly or between moderate (n = 203) and severe (n = 214) plagiocephaly. Younger respondents were more likely to consult a physician (uncorrected-P = 0.016) and choose helmet therapy (uncorrected-P = 0.004) for infants with normocephaly or mild plagiocephaly. Parents of children with physical disabilities were 6 times as likely as other participants to choose helmet therapy for mild plagiocephaly (corrected-P = 0.036).
Laypersons perceived moderate and severe plagiocephaly as equally abnormal and mild plagiocephaly as normal, consistent with their treatment preferences. Parents of physically disabled children were significantly more likely than other participants to choose helmet therapy. Our findings provide medical professionals with lay perspectives on positional plagiocephaly that may facilitate effective counseling of parents.
对于治疗姿势性斜头畸形，特别是使用头盔治疗，临床证据尚不确定，这给患者家长的咨询带来了困难。本研究旨在调查非专业人士对姿势性斜头畸形的看法和治疗偏好，为管理提供以患者为中心的证据。
通过众包招募成年非专业人士，观看正常、轻度、中度或重度斜头畸形婴儿头部的数字修改图像。参与者提供人口统计学信息，并对婴儿的头型和潜在相关社交困难程度进行评分，评估他们就诊寻求治疗选择的可能性，以及为婴儿寻求头盔治疗的可能性。
共有 945 人参与了这项研究。对于头型的感知、对未来尴尬和社交困难的预测、寻求医生评估的可能性、选择头盔治疗的可能性以及对头盔治疗的支付意愿在 4 种斜头畸形严重程度之间存在差异（所有校正 P 值均<0.001），除了正常头型（n=194）和轻度斜头畸形（n=334）之间或中度（n=203）和重度（n=214）斜头畸形之间。年轻的受访者更有可能为正常头型或轻度斜头畸形的婴儿咨询医生（未校正 P=0.016）和选择头盔治疗（未校正 P=0.004）。有身体残疾儿童的父母选择头盔治疗轻度斜头畸形的可能性是其他参与者的 6 倍（校正 P=0.036）。
非专业人士认为中度和重度斜头畸形同样异常，轻度斜头畸形正常，这与他们的治疗偏好一致。有身体残疾儿童的父母比其他参与者更有可能选择头盔治疗。我们的发现为医疗专业人员提供了关于姿势性斜头畸形的非专业观点，这可能有助于对家长进行有效的咨询。
