{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:26:23Z","timestamp":1791354383707,"version":"4.3.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":4064,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2005,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To investigate the extent of within\u2010system reliability and between\u2010system correlation for the \u201cSydney\u201d and \u201cSunnybrook\u201d systems of grading facial nerve paralysis, and to examine the interobserver reliability and agreement of the \u201cHouse Brackmann\u201d grading system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN:<\/jats:title>\n                    <jats:p>A fixed\u2010effects reliability study in which 6 otolaryngologists viewed videotapes of patients with facial nerve paralysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING:<\/jats:title>\n                    <jats:p>University and medical Centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS:<\/jats:title>\n                    <jats:p>Patients with unilateral lower motor neurone facial nerve dysfunction greater than 1 year after onset, none of whom had undergone surgical reanimation procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTION:<\/jats:title>\n                    <jats:p>Twenty\u2010one patients with facial nerve paralysis were videotaped while they performed a protocol of facial movements. Six otolaryngologists viewed the videotapes and scored them with the Sydney and Sunnybrook systems, and then gave a House Brackmann grade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN OUTCOME MEASURE:<\/jats:title>\n                    <jats:p>The 3 systems of grading facial nerve paralysis were evaluated and compared with the use of intraclass correlation coefficients, Pearson's weighted kappa, and percentage exact agreement values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The Sydney and the Sunnybrook systems had good intrasystem reliability and high intersystem association for the assessment of voluntary movement. Grading of synkinesis was found to have low reliability both within and between systems. The House Brackmann system had substantial reliability as shown by weighted kappa but had a percentage exact agreement of 44%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>For clinical grading of voluntary movement, there is good correlation between ratings given on the Sydney and Sunnybrook systems, and within each system there is good reliability. The assessment of synkinesis was far less reliable within, and less related between, systems. Although the reliability of the House Brackmann system was found to be high, examination of individual grades revealed some wide variation between trained observers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.otohns.2005.01.027","type":"journal-article","created":{"date-parts":[[2005,4,2]],"date-time":"2005-04-02T07:14:54Z","timestamp":1112426094000},"page":"543-549","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":188,"title":["Reliability of the \u201cSydney,\u201d \u201cSunnybrook,\u201d and \u201cHouse Brackmann\u201d Facial Grading Systems to Assess Voluntary Movement and Synkinesis after Facial Nerve Paralysis"],"prefix":"10.1002","volume":"132","author":[{"given":"Susan E.","family":"Coulson","sequence":"first","affiliation":[{"name":"School of Physiotherapy Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen R.","family":"Croxson","sequence":"additional","affiliation":[{"name":"University of Sydney, and the Royal Prince Alfred Hospital Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Adams","sequence":"additional","affiliation":[{"name":"School of Physiotherapy Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"O'dwyer","sequence":"additional","affiliation":[{"name":"School of Exercise and Sport Science Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300202"},{"key":"e_1_2_1_3_1","first-page":"240","article-title":"Grading facial nerve function: House\u2010Brackmann vs Burres\u2010Fisch methods","volume":"11","author":"Croxson G","year":"1990","journal-title":"Am J Otol"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(97)70120-7"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989670206-1"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1986.03780070067015"},{"key":"e_1_2_1_7_1","first-page":"667","article-title":"Rapid simultaneous comparison system for subjective grading scales for facial paralysis","volume":"20","author":"Ahrens A","year":"1999","journal-title":"Am J Otol"},{"issue":"1","key":"e_1_2_1_8_1","first-page":"20","article-title":"Assessing physiotherapy rehabilitation outcomes following facial nerve paralysis","volume":"2","author":"Coulson SE","year":"1995","journal-title":"Aust J Otolaryngol"},{"key":"e_1_2_1_9_1","volume-title":"Comparison of the \u201cSydney\u201d versus \u201cSunnybrook\u201d facial grading systems following long term facial nerve paralysis","author":"Coulson SE","year":"2002"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1531-4995.2002.tb00001.x"},{"key":"e_1_2_1_11_1","first-page":"46","volume-title":"Foundations of clinical research","author":"Portney LG","year":"1993"},{"key":"e_1_2_1_12_1","volume-title":"Statistical methods for health care research","author":"Munro BH","year":"1997"},{"key":"e_1_2_1_13_1","volume-title":"Practical statistics for medical research","author":"Altman DG","year":"1999"},{"key":"e_1_2_1_14_1","first-page":"1","volume-title":"The design and analysis of clinical experiments","author":"Fleiss LS","year":"1986"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2001.20148"},{"key":"e_1_2_1_17_1","first-page":"563","volume-title":"Reliability and validity of the Sunny\u2010brook facial grading system","author":"Ross BG","year":"1997"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(00)70241-5"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/75.10.854"},{"key":"e_1_2_1_20_1","first-page":"139","article-title":"The judgments of test bakers: A psychological study","volume":"12","author":"Katz D","year":"1938","journal-title":"Occupat Psychol"},{"key":"e_1_2_1_21_1","first-page":"61","article-title":"The subjective judgment of the elastic and plastic properties of soft bodies","volume":"31","author":"Scott\u2010Blair GW","year":"1940","journal-title":"Br J Psychol"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-4603.1993.tb01279.x"},{"key":"e_1_2_1_23_1","first-page":"431","volume-title":"The facial nerve","author":"May M","year":"2000"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197911000-00020"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199612000-00009"},{"key":"e_1_2_1_26_1","volume-title":"The ethics and practice of applied sport psychology","author":"Nideffer RM","year":"1981"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199604000-00009"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510011093X"},{"key":"e_1_2_1_29_1","first-page":"529","volume-title":"New horizons in facial nerve research and facial expression","author":"Friedman R","year":"1997"},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200301000-00023"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0194599805001208?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2005.01.027","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0194599805001208?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2005.01.027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:27:42Z","timestamp":1760952462000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2005.01.027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,4]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2005,4]]}},"alternative-id":["10.1016\/j.otohns.2005.01.027"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2005.01.027","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,4]]},"assertion":[{"value":"2016-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}