{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:24:02Z","timestamp":1777523042831,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T00:00:00Z","timestamp":1525996800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Can we reliably discriminate severity within the existing categories of the 5-Year-Olds\u2019 Index?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective method comparison and development study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>School of Oral and Dental Science, University of Bristol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Dental study models of 5-year-olds with unilateral cleft lip and palate (UCLP) were collected from the archives of 2 national cleft surveys (n = 351). One hundred randomly selected models were ranked to construct the modified 5-Year-Olds\u2019 Index and also scored using a visual analogue scale (VAS). Reliability testing was performed on 51 study models. Visual analogue scale scores were used to aid statistical analysis and investigate the reliability of a VAS for outcome measurement. The modified 5-Year-Olds\u2019 Index was then applied to 198 study models of 5-year-olds with UCLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The modified 5-Year-Olds\u2019 Index showed excellent intra and interexaminer agreement (intraclass correlation &gt; 0.94) and good discrimination of severity. When applied to the Cleft Care UK participants (n = 198), the modified 5-Year-Olds\u2019 Index showed good discrimination of severity within the better categories (groups 1-3) of the 5-Year-Olds\u2019 Index. Visual analogue Scale scores resulted in unacceptable variation between measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The new modified 5-Year-Olds\u2019 Index is a reliable method of assessing outcomes at 5 years of age and showed improved discriminatory power between the \u201cbetter\u201d outcome categories than the original 5-Year-Olds\u2019 Index. A VAS was found to be unsuitable for assessing outcome at 5 years of age for children with UCLP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665618774018","type":"journal-article","created":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T15:33:50Z","timestamp":1526052830000},"page":"248-256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcome Measures in UCLP: The Modified 5-Year-Olds\u2019-Index\u2014Development and Reliability"],"prefix":"10.1177","volume":"56","author":[{"given":"Tarun K.","family":"Mittal","sequence":"first","affiliation":[{"name":"Derriford Hospital, Crownhill, Plymouth, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Ireland","sequence":"additional","affiliation":[{"name":"Dental School, University of Bristol, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikki E.","family":"Atack","sequence":"additional","affiliation":[{"name":"Dental School, University of Bristol, Bristol, United Kingdom"},{"name":"Musgrove Park Hospital, Taunton, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam D.","family":"Leary","sequence":"additional","affiliation":[{"name":"Dental School, University of Bristol, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce I.","family":"Russell","sequence":"additional","affiliation":[{"name":"Alder Hey Children\u2019s Foundation Trust, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Deacon","sequence":"additional","affiliation":[{"name":"South West Cleft Service, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy R.","family":"Ness","sequence":"additional","affiliation":[{"name":"Dental School, University of Bristol, Bristol, United Kingdom"},{"name":"University Hospitals Bristol, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Sandy","sequence":"additional","affiliation":[{"name":"Dental School, University of Bristol, Bristol, United Kingdom"},{"name":"University Hospitals Bristol, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,5,11]]},"reference":[{"key":"bibr1-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12109"},{"key":"bibr2-1055665618774018","volume-title":"5 Year Olds\u2019 Index Calibration Handbook (Japan)","author":"Atack N","year":"2012"},{"key":"bibr3-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/19.2.165"},{"key":"bibr4-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1997_034_0242_anifas_2.3.co_2"},{"key":"bibr5-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01132.x"},{"key":"bibr6-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1016\/0010-4825(90)90013-F"},{"key":"bibr7-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"bibr8-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjr096"},{"issue":"1","key":"bibr9-1055665618774018","first-page":"1","volume":"1","author":"Doros G","year":"2010","journal-title":"Am J Biostat"},{"key":"bibr10-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1597\/09-052.1"},{"key":"bibr11-1055665618774018","volume-title":"Design and Analysis of Clinical Experiments","author":"Fleiss JL","year":"1986"},{"key":"bibr12-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1177\/001316447303300309"},{"key":"bibr13-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118863"},{"key":"bibr14-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(86)90228-9"},{"key":"bibr15-1055665618774018","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjw013"},{"key":"bibr16-1055665618774018","volume-title":"A Study to Determine the Optimal Outcome Measure to Assess Primary Surgery in Cleft Lip and Palate Patients and an Analysis of Five Year Old Patients as Part of the Cleft Care UK Study. 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