Degree of Agreement Between Different Classification Systems for Severity Levels of Positional Plagiocephaly

Area of Science:

• Pediatric medicine
• Medical imaging
• Biometrics

Background:

• Plagiocephaly, a common condition in infants, is often assessed using cranial measurements.
• Standardized classification of plagiocephaly severity is crucial for guiding clinical decisions.
• Existing measurement methods, such as difference between transcranial diagonals (DTD) and Cranial Vault Asymmetry Index (CVAi), have varying classification references.

Purpose of the Study:

• To evaluate the agreement between plagiocephaly severity classifications derived from DTD and CVAi measurements.
• To compare different classification systems based on DTD and CVAi found in the literature.

Main Methods:

• Observational study involving 50 infants with suspected plagiocephaly.
• 3D cranial scanning was utilized for diagnosis and obtaining cranial measurements.
• DTD (cm) and CVAi (%) were measured and classified into severity levels (absent, mild, moderate, severe) using multiple references (3 for DTD, 4 for CVAi).
• Agreement between classifications was analyzed using the kappa (κ) index.

Main Results:

• Agreement between DTD and CVAi classifications for plagiocephaly severity ranged from weak to moderate across all applied references.
• All statistical analyses demonstrated significant results.
• Discrepancies were observed in classifying the severity of cranial asymmetry.

Conclusions:

• The use of DTD and CVAi for classifying plagiocephaly severity demonstrates limited agreement across different literature references.
• Inconsistent classification of mild, moderate, or severe plagiocephaly can potentially lead to varied clinical treatment approaches.
• Further research may be needed to establish more consistent and reliable methods for plagiocephaly severity assessment.