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Reliability of Oronasal Fistula Classification.

Publication ,  Journal Article
Sitzman, TJ; Allori, AC; Matic, DB; Beals, SP; Fisher, DM; Samson, TD; Marcus, JR; Tse, RW; Americleft Task Force Surgeon Subgroup
Published in: Cleft Palate Craniofac J
July 2018

OBJECTIVE: Oronasal fistula is an important complication of cleft palate repair that is frequently used to evaluate surgical quality, yet reliability of fistula classification has never been examined. The objective of this study was to determine the reliability of oronasal fistula classification both within individual surgeons and between multiple surgeons. DESIGN: Using intraoral photographs of children with repaired cleft palate, surgeons rated the location of palatal fistulae using the Pittsburgh Fistula Classification System. Intrarater and interrater reliability scores were calculated for each region of the palate. PARTICIPANTS: Eight cleft surgeons rated photographs obtained from 29 children. RESULTS: Within individual surgeons reliability for each region of the Pittsburgh classification ranged from moderate to almost perfect (κ = .60-.96). By contrast, reliability between surgeons was lower, ranging from fair to substantial (κ = .23-.70). Between-surgeon reliability was lowest for the junction of the soft and hard palates (κ = .23). Within-surgeon and between-surgeon reliability were almost perfect for the more general classification of fistula in the secondary palate (κ = .95 and κ = .83, respectively). CONCLUSIONS: This is the first reliability study of fistula classification. We show that the Pittsburgh Fistula Classification System is reliable when used by an individual surgeon, but less reliable when used among multiple surgeons. Comparisons of fistula occurrence among surgeons may be subject to less bias if they use the more general classification of "presence or absence of fistula of the secondary palate" rather than the Pittsburgh Fistula Classification System.

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Published In

Cleft Palate Craniofac J

DOI

EISSN

1545-1569

Publication Date

July 2018

Volume

55

Issue

6

Start / End Page

871 / 875

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Reproducibility of Results
  • Practice Patterns, Physicians'
  • Postoperative Complications
  • Photography
  • Oral Fistula
  • Nose Diseases
  • Humans
  • Dentistry
  • Clinical Competence
 

Citation

APA
Chicago
ICMJE
MLA
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Sitzman, T. J., Allori, A. C., Matic, D. B., Beals, S. P., Fisher, D. M., Samson, T. D., … Americleft Task Force Surgeon Subgroup. (2018). Reliability of Oronasal Fistula Classification. Cleft Palate Craniofac J, 55(6), 871–875. https://doi.org/10.1597/16-186
Sitzman, Thomas J., Alexander C. Allori, Damir B. Matic, Stephen P. Beals, David M. Fisher, Thomas D. Samson, Jeffrey R. Marcus, Raymond W. Tse, and Americleft Task Force Surgeon Subgroup. “Reliability of Oronasal Fistula Classification.Cleft Palate Craniofac J 55, no. 6 (July 2018): 871–75. https://doi.org/10.1597/16-186.
Sitzman TJ, Allori AC, Matic DB, Beals SP, Fisher DM, Samson TD, et al. Reliability of Oronasal Fistula Classification. Cleft Palate Craniofac J. 2018 Jul;55(6):871–5.
Sitzman, Thomas J., et al. “Reliability of Oronasal Fistula Classification.Cleft Palate Craniofac J, vol. 55, no. 6, July 2018, pp. 871–75. Pubmed, doi:10.1597/16-186.
Sitzman TJ, Allori AC, Matic DB, Beals SP, Fisher DM, Samson TD, Marcus JR, Tse RW, Americleft Task Force Surgeon Subgroup. Reliability of Oronasal Fistula Classification. Cleft Palate Craniofac J. 2018 Jul;55(6):871–875.

Published In

Cleft Palate Craniofac J

DOI

EISSN

1545-1569

Publication Date

July 2018

Volume

55

Issue

6

Start / End Page

871 / 875

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Reproducibility of Results
  • Practice Patterns, Physicians'
  • Postoperative Complications
  • Photography
  • Oral Fistula
  • Nose Diseases
  • Humans
  • Dentistry
  • Clinical Competence