Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome?

David G.M. Mosmuller, Thomas J. Maal, Charlotte Prahl, Robin A. Tan, Frans J. Mulder, Roderic M.F. Schwirtz, Henrica C.W. de Vet, Stefaan J. Bergé, J. P.W. Don Griot

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. Methods The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. Results The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38–0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08–0.17). Conclusion Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.

Original languageEnglish
Pages (from-to)1220-1226
Number of pages7
JournalJournal of Cranio-Maxillofacial Surgery
Volume45
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Cite this

@article{ba9a582fe5444e9291672e1f6f4ac170,
title = "Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome?",
abstract = "Objective For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. Methods The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. Results The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38–0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08–0.17). Conclusion Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.",
keywords = "2D assessment, 3D assessment, Aesthetic assessment, Asymmetry assessment, Cleft lip and palate, Nasolabial appearance",
author = "Mosmuller, {David G.M.} and Maal, {Thomas J.} and Charlotte Prahl and Tan, {Robin A.} and Mulder, {Frans J.} and Schwirtz, {Roderic M.F.} and {de Vet}, {Henrica C.W.} and Berg{\'e}, {Stefaan J.} and {Don Griot}, {J. P.W.}",
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volume = "45",
pages = "1220--1226",
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}

Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients : Do the assessment methods measure the same outcome? / Mosmuller, David G.M.; Maal, Thomas J.; Prahl, Charlotte; Tan, Robin A.; Mulder, Frans J.; Schwirtz, Roderic M.F.; de Vet, Henrica C.W.; Bergé, Stefaan J.; Don Griot, J. P.W.

In: Journal of Cranio-Maxillofacial Surgery, Vol. 45, No. 8, 01.08.2017, p. 1220-1226.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients

T2 - Do the assessment methods measure the same outcome?

AU - Mosmuller, David G.M.

AU - Maal, Thomas J.

AU - Prahl, Charlotte

AU - Tan, Robin A.

AU - Mulder, Frans J.

AU - Schwirtz, Roderic M.F.

AU - de Vet, Henrica C.W.

AU - Bergé, Stefaan J.

AU - Don Griot, J. P.W.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objective For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. Methods The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. Results The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38–0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08–0.17). Conclusion Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.

AB - Objective For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. Methods The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. Results The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38–0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08–0.17). Conclusion Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.

KW - 2D assessment

KW - 3D assessment

KW - Aesthetic assessment

KW - Asymmetry assessment

KW - Cleft lip and palate

KW - Nasolabial appearance

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U2 - 10.1016/j.jcms.2017.04.004

DO - 10.1016/j.jcms.2017.04.004

M3 - Article

VL - 45

SP - 1220

EP - 1226

JO - Journal of Cranio-Maxillo-Facial Surgery

JF - Journal of Cranio-Maxillo-Facial Surgery

SN - 1010-5182

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ER -