Determining the accuracy of screening for surgically actionable craniosynostosis through the assessment of caregiver provided photographs
department or school: Medicine, Faculty of
department or school: Medicine, Department of
data provider: DSpace
degree campus: UBCV
creator: Cheong, Alexander Ryan
issued: 2021-09-15T15:55:25Z
issued: 2021
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Introduction: Assessment of head shape is a common reason for referrals to pediatric neurosurgery clinics. To streamline patient assessments, we investigated whether craniofacial practitioners can accurately screen for surgically actionable craniosynostosis by using standardized screening photographs provided by parents. Methods: Parents of children referred to the neurosurgery clinic at BC Children’s Hospital for assessment of a suspected abnormal head shape prospectively submitted a series of standardized photographs which were blindly evaluated by a panel of 7 independent raters, made up of 3 neurosurgeons, 2 plastic surgeons, a pediatrician, and an occupational therapist, both with experience running a head shape clinic. Each rater indicated their likely diagnosis (presence or absence of potentially surgically actionable craniosynostosis) and their level of confidence in that diagnosis. All children were subsequently evaluated in person by an experienced pediatric neurosurgeon with or without the additional consultation of a plastic surgeon. The diagnosis made at the time of in-person evaluation was used as the gold standard. Results: Of 74 children evaluated, 24 (32.4%) had craniosynostosis diagnosed during an in-person assessment. Fleiss-kappa, a measure of assessing agreement among raters, amongst all 7 raters was 0.76 (0.69, 0.82), indicating substantial agreement related to the diagnosis of craniosynostosis based on photographic assessment. Individual raters' diagnostic performance based on photographic evaluation (sensitivity range 0.86-1.0; specificity range 0.77-0.90) compared favourably with the performance of the "majority rule" photographic diagnosis of all 7 raters combined [sensitivity=1.0 (0.88, 1.0); specificity=0.88 (0.76, 0.95)], or the 3 neurosurgeons [sensitivity=1.0 (0.85, 1.0); specificity=0.88 (0.76, 0.95)]. Conclusion: Based on the evaluation of standardized photographs, experienced craniofacial practitioners were able to accurately identi…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/79715
note: Determining the Accuracy of Screening for Surgically Actionable Craniosynostosis Through the Assessment of Caregiver Provided Photographs by Alexander Ryan Cheong B.Sc., Simon Fraser University, 2015 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Experimental Medicine) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) July 2021 © Alexander Ryan Cheong, 2021 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, a thesis entitled: Determining the Accuracy of Identifying Surgically Actionable Craniosynostosis Through the Assessment of Caregiver Provided Photographs submitted by Alexander Cheong in partial fulfillment of the requirements for the degree of Master of Science in Experimental Medicine Examining Committee: Ash Singhal, Department of Surgery, UBC Co-supervisor Patrick McDonald, Department of Surgery, UBC Co-supervisor Erik Skarsgard, Department of Surgery, UBC Supervisory Committee Member Andrew MacNeily, Department of Urologic Sciences, UBC Additional Examiner iii Abstract Introduction: Assessment of head shape is a common reason for referrals to pediatric neurosurgery clinics. To streamline patient assessments, we investigated whether craniofacial practitioners can accurately screen for surgically actionable craniosynostosis by using standardized screening photographs provided by parents. Methods: Parents of children referred to the neurosurgery clinic at BC Children’s Hospital for assessment of a suspected abnormal head shape prospectively submitted a series of standardized photographs which were blindly evaluated by a panel of 7 independent raters, made up of 3 neurosurgeons, 2 plastic surgeons, a pediatrician, and an occupational therapist, both with experience running a head shape clinic. Each rater indicated their likely diagnosis (presence or absence of potentially su…
has type: Thesis/Dissertation
date issued: 2021-11
is shown at: 10.14288/1.0402144
language: eng
degree discipline: Experimental Medicine
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Singhal, Ash
contributor: McDonald, Patrick
type: Text
identifier URI: http://hdl.handle.net/2429/79715