Related Experiment Video
Updated: May 14, 2025
Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
Are we all seeing the same thing? Discrepancies between parent-reported and physician-reported positional
Grace Soojin Ryu1, Mary Newland2, Andrea Hiller3
1College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA. gryu@pennstatehealth.psu.edu.
Insights
Provider and guardian assessments of infant head shape conditions like positional plagiocephaly and brachycephaly show similar severity scores. These findings can help reduce parental anxiety regarding infant head shape.
Area of Science:
- Pediatric medicine
- Craniosynostosis and skull deformities
Background:
- Positional plagiocephaly (PP) and brachycephaly are common infant head shape deformities.
- The incidence of these conditions has increased following the American Academy of Pediatrics' "Back to Sleep" campaign.
- Understanding parental perception of head shape is crucial for managing infant care and parental anxiety.
Purpose of the Study:
- To compare provider and guardian perceptions of head shape severity in infants with positional plagiocephaly and brachycephaly.
- To evaluate the utility of standardized assessment tools in quantifying head shape deformities.
- To explore how similar scoring can alleviate parental concerns regarding infant head shape.
Main Methods:
- A retrospective chart review of 59 pediatric patients diagnosed with positional plagiocephaly or brachycephaly between January 2018 and November 2023.
- Collected and analyzed provider and guardian-reported severity scores using validated qualitative assessment forms.
- Plagiocephaly was assessed on a 15-point scale and brachycephaly on a 9-point scale.
Main Results:
- For positional plagiocephaly, provider and guardian median severity scores were similar (4 vs. 4).
- For brachycephaly, provider and guardian mean severity scores showed a statistically significant difference (3.59 vs. 4.69, p < 0.005).
- Both conditions, on average, were rated as mild to moderate in severity.
Conclusions:
- Standardized qualitative assessments reveal comparable provider and parent perceptions of infant head shape severity.
- Positional plagiocephaly is generally perceived as mild, while brachycephaly ranges from mild to moderate.
- Further research is needed to understand the impact of patient-provider interactions on parental scores and shared decision-making.
Purpose:
Positional plagiocephaly (PP) and brachycephaly are conditions characterized by head flattening. There has been a sharp rise in the number of patients diagnosed since the American Academy of Pediatrics initiated the "Back to Sleep" policy to combat sudden infant death syndrome. This study compares providers' and guardians' perceived head shape differences, highlighting how these scores can alleviate parental anxiety.
Methods:
A retrospective chart review was performed for all pediatric patients seen for a PP consult from January 2018 to November 2023. Fifty-nine patients (43 with plagiocephaly and 16 with brachycephaly) met the inclusion criteria, in which documentation recorded two severity scores, one rating each by the provider and parental guardian. Patient demographics, severity scores, and comorbidities were recorded. The institution utilized validated, qualitative assessment forms that evaluated plagiocephaly on a 15-point scale and brachycephaly on a 9-point scale.
Results:
For plagiocephaly, the providers and guardians rated severity with a median of 4 (IQR 3-4.5) and 4 (IQR 3-7), respectively (Wilcoxon signed rank test, p-value < 0.05). For brachycephaly, the providers and guardians rated severity with a mean of 3.59 (SD 1.28) and 4.69 (SD 1.66), respectively (paired T-test, p-value < 0.005).
Conclusions:
Our study highlights the similarities in scores assessing clinical severity between providers and parents evaluated in a standardized, qualitative assessment for PP. On average, plagiocephaly reflected a "mild" severity, while brachycephaly reflected a "mild" to "moderate" severity on a graded scale. Future studies are needed to determine how patient-provider interactions may influence parents' scores through shared decision-making.
