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Artificial Intelligence Methods for the Argenta Classification of Deformational Plagiocephaly to Predict Severity and
Huan T Nguyen1, Chioma G Obinero2, Ellen Wang2
1Division of Plastic and Reconstructive Surgery, University of Missouri School of Medicine, Columbia, MO.
Insights
Artificial intelligence (AI) can objectively classify deformational plagiocephaly (DP) severity using infant head photographs. This AI tool aids primary care pediatricians in identifying infants needing craniofacial surgery referral.
Area of Science:
- Medical technology
- Artificial intelligence in healthcare
- Pediatric surgery
Background:
- Deformational plagiocephaly (DP) is classified by the Argenta scale (AS), with type III or higher requiring surgical referral.
- Primary care pediatricians (PCPs) face challenges in subjective DP screening, risking bias and delayed referrals.
- Artificial intelligence (AI) offers a potential solution for objective DP assessment.
Purpose of the Study:
- To develop and evaluate an AI tool for classifying DP severity using the Argenta scale (AS).
- To assess the AI's accuracy in identifying infants requiring craniofacial surgery referral.
Main Methods:
- An AI program was developed to classify infant head contour photographs into three AS groups.
- The AI was trained on photographs with clinically confirmed DP severity by craniofacial surgeons.
- The AI's AS predictions were compared against clinical diagnoses for accuracy assessment.
Main Results:
- The AI correctly classified 100% of type I DP cases (3/3 patients).
- The AI achieved 67% accuracy for type II DP (4/6 patients).
- The AI correctly identified 70% of patients with type III or greater DP (7/10 patients).
Conclusions:
- AI can objectively classify DP severity from vertex photographs, aiding clinical decision-making.
- A smartphone application of this AI could empower PCPs, especially in remote or low-resource areas.
- Objective AI-driven assessment can improve the identification of infants needing craniofacial surgery referral.
Introduction:
Deformational plagiocephaly (DP) can be classified into 5 severity types using the Argenta scale (AS). Patients with type III or higher require referral to craniofacial surgery for management. Primary care pediatricians (PCPs) are often the first to encounter patients with DP, but current screening methods are subjective, increasing the risk of bias, especially for clinicians with little exposure to this population. The authors propose the use of artificial intelligence (AI) to classify patients with DP using the AS and to make recommendations for referral to craniofacial surgery.
Methods:
Vertex photographs were obtained for patients diagnosed with unilateral DP from 2019 to 2020. Using the photographs, an AI program was created to characterize the head contour of these infants into 3 groups based on the AS. The program was trained using photographs from patients whose DP severity was confirmed clinically by craniofacial surgeons. To assess the accuracy of the software, the AS predicted by the program was compared with the clinical diagnosis.
Results:
Nineteen patients were assessed by the AI software. All 3 patients with type I DP were correctly classified by the program (100%). In addition, 4 patients with type II were correctly identified (67%), and 7 were correctly classified as type III or greater (70%).
Conclusions:
Using vertex photographs and AI, the authors were able to objectively classify patients with DP based on the AS. If converted into a smartphone application, the program could be helpful to PCPs in remote or low-resource settings, allowing them to objectively determine which patients require referral to craniofacial surgery.
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