title: The Asher-McDade Aesthetic Index in Comparison With Two Scoring Systems in Nonsyndromic Complete Unilateral Cleft Lip and Palate Patients.
abstract: OBJECTIVE
  To compare the Asher-McDade aesthetic index with 2 systems used to score the appearance of the nasolabial area in patients with a complete cleft lip and palate.
  
  
  METHODS
  Retrospective analysis of the results of complete unilateral cleft lip and palate patients.
  
  
  METHODS
  Academic Center for Dentistry of Amsterdam and the VU University Medical Center.
  
  
  METHODS
  Six-year-olds with complete unilateral cleft lip and palate.
  
  
  METHODS
  Cleft lip and palate patients assessed using the scoring system proposed by Prahl et al, a 5-point ordinal scale, and the scoring system proposed by Asher-McDade et al by 6 judges, 3 orthodontists, and 3 plastic surgeons. A calculation of intra- and interobserver reliability was made. A comparison was made of all the assessment methods using Kendalls' tau.
  
  
  RESULTS
  Photographs of 55 children (38 boys and 17 girls) with complete unilateral cleft lip and palate were assessed. For the scoring system of Prahl et al, interobserver reliability varied from 0.43 to 0.53, for the 5-point scale between 0.45 and 0.57, and for the scoring system by Asher-McDade et al these varied between 0.52 and 0.66. Multiple significant correlations were found between the used scoring systems.
  
  
  CONCLUSIONS
  It can be concluded that the Asher-McDade aesthetic index is still superior to the other scoring systems used in this study. However, all 3 scoring systems can reliably be used when 3 or more observers are used.
authors.affiliation: *Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center Amsterdam, HV Amsterdam, The Netherlands †Department of Maxillofacial Surgery, Shenzhen's Childrens Hospital, Fu Tian District, Shenzhen, China ‡Department of Orthodontics, Academic Center for Dentistry, LA Amsterdam §Department of Medical Statistics, VU University Medical Center Amsterdam, HV Amsterdam, The Netherlands.
authors.forename: D G M
authors.initials: DG
authors.lastname: Mosmuller
authors.forename: C L
authors.initials: CL
authors.lastname: Bijnen
authors.forename: G J C
authors.initials: GJ
authors.lastname: Kramer
authors.forename: M A
authors.initials: MA
authors.lastname: Disse
authors.forename: C
authors.initials: C
authors.lastname: Prahl
authors.forename: D J
authors.initials: DJ
authors.lastname: Kuik
authors.forename: F B
authors.initials: FB
authors.lastname: Niessen
authors.forename: J P W
authors.initials: JP
authors.lastname: Don Griot
mesh_terms: D002648:Child; D002971:Cleft Lip / Q000523:psychology / Q000601:surgery*; D002972:Cleft Palate / Q000523:psychology / Q000601:surgery*; D004954:Esthetics / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000941:ethics*; D019651:Plastic Surgery Procedures / Q000523:psychology*; D015203:Reproducibility of Results; D012189:Retrospective Studies