{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:46:19Z","timestamp":1792183579580,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Facemask ventilation is a key airway management skill but predicting difficulty can be challenging. Pre\u2010operative three\u2010dimensional face scanning may have diagnostic value. We aimed to identify interpretable facial shape features and to quantify their value for predicting difficult facemask ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational single\u2010centre study, pre\u2010operative three\u2010dimensional face scans were obtained, and a structured airway assessment was performed on patients undergoing ear, nose and throat or maxillofacial surgery. The primary outcome was difficult facemask ventilation documented as an alert in the patient health record. After postprocessing, three\u2010dimensional face scans were fitted to an established, non\u2010clinical facial model to identify interpretable shape coefficients. The area under the receiver operating characteristic (AUROC) curve for the DIFFMASK score was calculated before and after enrichment with three facial shape features and the added diagnostic value was assessed using likelihood ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 398 patients were analysed. The optimism\u2010corrected AUROC was 0.73 (95%CI 0.65\u20130.80) for the DIFFMASK score and 0.74 (95%CI 0.66\u20130.82) for selected facial shape features. Enrichment of the DIFFMASK score with three facial shape features improved goodness of model fit (p\u2009=\u20090.002) and achieved an optimism\u2010corrected AUROC of 0.76 (95%CI 0.68\u20130.82). Generated face meshes with superimposed colour mapping revealed that morphological features of the nose, lower mandible, neck region and facial convexity were most predictive of difficult facemask ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Pre\u2010operative three\u2010dimensional face scans predicted difficult facemask ventilation at least as well as the DIFFMASK score. Integrating the features of three selected facial shapes enriched the DIFFMASK score and improved its diagnostic value. Digital phenotyping can complement traditional clinical assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70261","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T06:00:33Z","timestamp":1780725633000},"page":"1340-1348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pre\u2010operative three\u2010dimensional face scans for predicting difficult facemask ventilation: a prospective development study"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2669-0084","authenticated-orcid":false,"given":"Viktor A.","family":"W\u00fcnsch","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Bommes","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Germer","sequence":"additional","affiliation":[{"name":"Institute for Applied Medical Informatics University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Piltan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Breitfeld","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Institute for Applied Medical Informatics University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Latus","sequence":"additional","affiliation":[{"name":"Institute of Medical Technology and Intelligent Systems Hamburg University of Technology  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Krause","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry and Epidemiology University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Z\u00f6llner","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gundler","sequence":"additional","affiliation":[{"name":"Institute for Applied Medical Informatics University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5295-2925","authenticated-orcid":false,"given":"Martin","family":"Petzoldt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg 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