title: Which index should be used to measure primary surgical outcome for unilateral cleft lip and palate patients?
abstract: To determine the optimal dentoalveolar measure to assess unilateral cleft lip and palate (UCLP) patient plaster models.
  
  
  
  The models of 34 patients with UCLP taken at 5, 10, and 15-20 years of age were scored by two examiners on two separate occasions using five indices: the 5 Year Olds' (5YO), GOSLON, Modified Huddart/Bodenham (MHB), EUROCRAN, and Overjet. Reliability, validity, and ease of use were recorded for each index/examiner.
  
  
  
  All models were scored in either Bristol Dental Hospital or Derriford Hospital, Plymouth, United Kingdom by senior orthodontic clinicians.
  
  
  
  Highest overall reliability was seen with MHB (Kappa = 0.56-0.97). Predictive validity was similar for MHB, GOSLON, and 5YO with a 50-65 per cent prediction of final outcome from 5 and 10 years. EUROCRAN palatal index showed no clear predictive validity (Spearman's correlation = 0.20-0.21). Agreement to the gold standard 5YO score at the 5-year age group was high for MHB (Kappa = 0.83) and moderate for GOSLON (Kappa = 0.59). Agreement to the gold standard GOSLON score at 10 years was highest for 5YO (Kappa = 0.69), followed by Overjet (Kappa = 0.59) and MHB (Kappa = 0.46). Time to score 34 models per index (minutes): GOSLON (13.4) < Overjet (13.6) < 5YO (19.4) < EUROCRAN (24.8) < MHB (27.4).
  
  
  
  As an outcome measure of UCLP models, only MHB and 5YO indices can be recommended for use at 5 years of age and GOSLON at 10 years of age.
authors.affiliation: School of Oral and Dental Sciences, Bristol Dental Hospital, UK and Musgrove Park Hospital, Taunton, UK timemjones@yahoo.co.uk.
authors.forename: Timothy
authors.initials: T
authors.lastname: Jones
authors.affiliation: School of Oral and Dental Sciences, Bristol Dental Hospital, UK and.
authors.forename: Sam
authors.initials: S
authors.lastname: Leary
authors.affiliation: School of Oral and Dental Sciences, Bristol Dental Hospital, UK and Musgrove Park Hospital, Taunton, UK.
authors.forename: Nikki
authors.initials: N
authors.lastname: Atack
authors.affiliation: School of Oral and Dental Sciences, Bristol Dental Hospital, UK and.
authors.forename: Tony
authors.initials: T
authors.lastname: Ireland
authors.affiliation: School of Oral and Dental Sciences, Bristol Dental Hospital, UK and.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sandy
mesh_terms: D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000175:diagnosis; D003765:Models, Dental; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D006113:United Kingdom