Division of Orthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Orthod Craniofac Res. 2023 Nov;26(4):660-666. doi: 10.1111/ocr.12663. Epub 2023 Apr 16.
To compare the perspective of healthcare providers (orthodontists), cleft patients and laypersons in judging nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using 2 scoring systems.
This cross-sectional study was conducted in a tertiary care government hospital.
Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years (mean age-12.2 ± 3.93 years) were included in this study.
Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years were included. A panel of 3 orthodontists, 3 laypersons and 3 cleft patients rated nasolabial aesthetics using 2 scoring systems i.e. Asher-McDade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Spearman's split-half reliability, Intra-class correlation coefficient and Cronbach's alpha were computed to measure internal consistency and reliability. Inter-panel agreement between pair of groups was determined by means of Spearman correlation coefficient.
Estimated reliability of CARS for 3 raters in each panel was in moderate agreement for orthodontists and cleft patients (0.849 and 0.810). Good repeatability and agreement were recorded with moderate to high intra-panel reliability for all parameters of both AMAI and CARS. Overall inter-panel agreement was moderate for both AMAI and CARS. Pair-wise inter-panel agreement showed a moderately positive correlation in both scales (AMAI and CARS) by cleft patients and professionals.
CARS index can be reliably used for assessment of nasolabial aesthetics by cleft patients, professionals and lay persons on 2D facial photographs. Patients were more critical than clinicians and laypersons using both indices (CARS and AMAI) as they are more self-aware and conscious. Thus, a clear communication between clinician and patient regarding expectations, perception and satisfaction with surgical results is strongly recommended.
使用两种评分系统，比较正畸医生、唇腭裂患者和非专业人士在判断单侧完全唇腭裂（UCL±P）患者鼻唇美学方面的观点。
这是一项在三级政府医院进行的横断面研究。
本研究纳入了 100 名年龄在 5-18 岁（平均年龄 12.2±3.93 岁）的单侧完全唇腭裂患者的照片记录。
本研究纳入了 100 名单侧完全唇腭裂患者的照片记录。由 3 名正畸医生、3 名非专业人士和 3 名唇腭裂患者组成的专家组使用两种评分系统（Asher-McDade 指数（AMAI）和唇腭裂美学评分量表（CARS））对鼻唇美学进行评分。使用 Spearman 分割半可靠性、组内相关系数和 Cronbach's alpha 来衡量内部一致性和可靠性。通过 Spearman 相关系数确定两组之间的组间一致性。
在每个专家组中，CARS 对 3 名评分者的估计可靠性为中等一致性，适用于正畸医生和唇腭裂患者（0.849 和 0.810）。AMAI 和 CARS 的所有参数均记录了良好的可重复性和一致性，具有中等至高度的组内可靠性。两种量表（AMAI 和 CARS）的总体组间一致性为中等。在两个量表中，唇腭裂患者和专业人员的组间一致性都表现出中度正相关。
CARS 指数可用于唇腭裂患者、专业人员和非专业人员通过二维面部照片评估鼻唇美学。患者比临床医生和非专业人士使用两种指数（CARS 和 AMAI）更具批判性，因为他们更具自我意识和自我意识。因此，强烈建议临床医生与患者就手术结果的期望、感知和满意度进行清晰沟通。
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