Clinical classification of deformational plagiocephaly according to Argenta: a reliability study

Jacco Spermon, Renee Spermon-Marijnen, Wendy Scholten-Peeters

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

The incidence of deformational plagiocephaly (DP) in primary health care is increasing. Patients are referred and treated by different practitioners. However, reliable and practical assessment tools in clinical practice are lacking. The clinical classification according to Argenta distinguishes 5 types of DP based on severity of asymmetry of the skull, ear position, and face. The aim of this study was to investigate the reliability of this clinical classification of DP. Twenty referred patients aged 0 to 1 year were classified for DP. Raters from 3 different professions (3 infant health care physicians, 3 pediatric physiotherapists, and 3 manual therapists) were used because these professionals are the first ones who see children with DP in clinical practise. Interrater and intrarater reliability was determined for the type of DP (I-V) and each characteristic clinical feature separately. There was a moderate overall interrater agreement for classifying DP (mean weighted kappa, 0.54), whereas intrarater agreement ranged from 0.60 to 0.85, indicating substantial to almost perfect agreement. Kappa scores of the first 4 clinical features of DP (occipital flattening, ear malposition, frontal bossing, and facial asymmetry) ranged from 0.45 to 0.57 for the interrater reliability and 0.47 to 1 for the intrarater reliability, except for 1 score of -0.14. Agreement for the fifth feature (vertical skull growth) was due to chance (kappa approximately 0). The classification according to Argenta is a moderately reliable method for classifying DP in clinical practice.

Original languageEnglish
Pages (from-to)664-8
Number of pages5
JournalJournal of Craniofacial Surgery
Volume19
Issue number3
DOIs
Publication statusPublished - 2008

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Nonsynostotic Plagiocephaly
Skull
Ear
Facial Asymmetry
Infant Care
Physical Therapists
Primary Health Care

Keywords

  • Ear Deformities, Acquired
  • Facial Asymmetry
  • Frontal Bone
  • Humans
  • Infant
  • Infant, Newborn
  • Maxillofacial Development
  • Observer Variation
  • Plagiocephaly, Nonsynostotic
  • Journal Article
  • Validation Studies

Cite this

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title = "Clinical classification of deformational plagiocephaly according to Argenta: a reliability study",
abstract = "The incidence of deformational plagiocephaly (DP) in primary health care is increasing. Patients are referred and treated by different practitioners. However, reliable and practical assessment tools in clinical practice are lacking. The clinical classification according to Argenta distinguishes 5 types of DP based on severity of asymmetry of the skull, ear position, and face. The aim of this study was to investigate the reliability of this clinical classification of DP. Twenty referred patients aged 0 to 1 year were classified for DP. Raters from 3 different professions (3 infant health care physicians, 3 pediatric physiotherapists, and 3 manual therapists) were used because these professionals are the first ones who see children with DP in clinical practise. Interrater and intrarater reliability was determined for the type of DP (I-V) and each characteristic clinical feature separately. There was a moderate overall interrater agreement for classifying DP (mean weighted kappa, 0.54), whereas intrarater agreement ranged from 0.60 to 0.85, indicating substantial to almost perfect agreement. Kappa scores of the first 4 clinical features of DP (occipital flattening, ear malposition, frontal bossing, and facial asymmetry) ranged from 0.45 to 0.57 for the interrater reliability and 0.47 to 1 for the intrarater reliability, except for 1 score of -0.14. Agreement for the fifth feature (vertical skull growth) was due to chance (kappa approximately 0). The classification according to Argenta is a moderately reliable method for classifying DP in clinical practice.",
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Clinical classification of deformational plagiocephaly according to Argenta : a reliability study. / Spermon, Jacco; Spermon-Marijnen, Renee; Scholten-Peeters, Wendy.

In: Journal of Craniofacial Surgery, Vol. 19, No. 3, 2008, p. 664-8.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Clinical classification of deformational plagiocephaly according to Argenta

T2 - a reliability study

AU - Spermon, Jacco

AU - Spermon-Marijnen, Renee

AU - Scholten-Peeters, Wendy

PY - 2008

Y1 - 2008

N2 - The incidence of deformational plagiocephaly (DP) in primary health care is increasing. Patients are referred and treated by different practitioners. However, reliable and practical assessment tools in clinical practice are lacking. The clinical classification according to Argenta distinguishes 5 types of DP based on severity of asymmetry of the skull, ear position, and face. The aim of this study was to investigate the reliability of this clinical classification of DP. Twenty referred patients aged 0 to 1 year were classified for DP. Raters from 3 different professions (3 infant health care physicians, 3 pediatric physiotherapists, and 3 manual therapists) were used because these professionals are the first ones who see children with DP in clinical practise. Interrater and intrarater reliability was determined for the type of DP (I-V) and each characteristic clinical feature separately. There was a moderate overall interrater agreement for classifying DP (mean weighted kappa, 0.54), whereas intrarater agreement ranged from 0.60 to 0.85, indicating substantial to almost perfect agreement. Kappa scores of the first 4 clinical features of DP (occipital flattening, ear malposition, frontal bossing, and facial asymmetry) ranged from 0.45 to 0.57 for the interrater reliability and 0.47 to 1 for the intrarater reliability, except for 1 score of -0.14. Agreement for the fifth feature (vertical skull growth) was due to chance (kappa approximately 0). The classification according to Argenta is a moderately reliable method for classifying DP in clinical practice.

AB - The incidence of deformational plagiocephaly (DP) in primary health care is increasing. Patients are referred and treated by different practitioners. However, reliable and practical assessment tools in clinical practice are lacking. The clinical classification according to Argenta distinguishes 5 types of DP based on severity of asymmetry of the skull, ear position, and face. The aim of this study was to investigate the reliability of this clinical classification of DP. Twenty referred patients aged 0 to 1 year were classified for DP. Raters from 3 different professions (3 infant health care physicians, 3 pediatric physiotherapists, and 3 manual therapists) were used because these professionals are the first ones who see children with DP in clinical practise. Interrater and intrarater reliability was determined for the type of DP (I-V) and each characteristic clinical feature separately. There was a moderate overall interrater agreement for classifying DP (mean weighted kappa, 0.54), whereas intrarater agreement ranged from 0.60 to 0.85, indicating substantial to almost perfect agreement. Kappa scores of the first 4 clinical features of DP (occipital flattening, ear malposition, frontal bossing, and facial asymmetry) ranged from 0.45 to 0.57 for the interrater reliability and 0.47 to 1 for the intrarater reliability, except for 1 score of -0.14. Agreement for the fifth feature (vertical skull growth) was due to chance (kappa approximately 0). The classification according to Argenta is a moderately reliable method for classifying DP in clinical practice.

KW - Ear Deformities, Acquired

KW - Facial Asymmetry

KW - Frontal Bone

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Maxillofacial Development

KW - Observer Variation

KW - Plagiocephaly, Nonsynostotic

KW - Journal Article

KW - Validation Studies

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DO - 10.1097/SCS.0b013e31816ae3ec

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EP - 668

JO - Journal of Craniofacial Surgery

JF - Journal of Craniofacial Surgery

SN - 1049-2275

IS - 3

ER -