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Related Experiment Video

Updated: Nov 18, 2025

An Objective and Child-friendly Assessment of Arm Function by Using a 3-D Sensor
07:25

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Developing a Parental-Friendly Scoring System for Children with Congenital Hand Differences.

Wee Leon Lam1, Christopher Arthur James Trew2, Lauren Wong2

  • 1Department of Plastic Surgery, Royal Hospital for Sick Children, Edinburgh, UK.

The Journal of Hand Surgery Asian-Pacific Volume
|February 9, 2021
PubMed
Summary

A new scoring system improved understanding of congenital hand differences (CHD) severity between surgeons and parents. This classification aids in managing expectations and reducing anxiety for families facing CHD.

Keywords:
ClassificationCongenital handsQuestionnaireSeverity

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Area of Science:

  • Pediatric Surgery
  • Orthopedics
  • Medical Communication

Background:

  • Congenital hand differences (CHD) present significant diversity, leading to discrepancies in perceived severity between surgeons and parents.
  • This disparity complicates effective parental consultation and expectation management.

Purpose of the Study:

  • To develop and validate a novel severity classification system for congenital hand differences (CHD).
  • To align surgeon and parental perceptions of CHD severity and prognosis.
  • To assess the impact of the classification system on parental understanding and anxiety.

Main Methods:

  • Parents rated CHD severity and concerns (function, appearance) on a 1-4 scale before and after consultation.
  • A 4-point scale defining treatment outcomes was explained to parents.
  • Surgeons independently scored CHD severity using the same scale.
  • Inter-rater reliability (kappa) was calculated pre- and post-explanation and post-operatively.

Main Results:

  • Initial scoring showed no agreement between surgeons and parents.
  • Agreement significantly improved after explanation (kappa = 0.437) and post-operatively (kappa = 0.706).
  • No correlation was found between perceived severity and hand function or appearance.

Conclusions:

  • A simple, explained scoring system effectively bridges the understanding gap regarding CHD severity between surgeons and parents.
  • The classification system demonstrates good inter-rater reliability and can be implemented in outpatient settings.
  • Utilizing this tool can significantly improve parental understanding, manage expectations, and reduce anxiety associated with congenital hand differences.