{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:19:51Z","timestamp":1783167591753,"version":"3.54.6"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Presurgical infant orthopedics (PSIO) is used to optimize anatomical outcomes in infants with cleft lip and palate to facilitate favorable surgical results. However, standardized, reliable tools to assess PSIO effectiveness are lacking due to phenotypic variability and diverse treatment protocols. This study aimed to develop and perform a preliminary reliability assessment of a novel phenotype-based clinical outcome assessment tool, the PSIO Assessment Tool (PAT), to assess PSIO-related morphological changes in unilateral and bilateral cleft lip with or without palate.vd<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Tool Development and Reliability Assessment Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multicentre expert consensus involving craniofacial orthodontists from diverse global regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Standardized pretreatment and post-treatment clinical cases of unilateral and bilateral cleft lip and alveolus with or without palate were used for calibration and reliability assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A panel of 7 expert craniofacial orthodontists collaboratively developed the PAT through iterative calibration using clinical cases. The tool assesses cleft severity pretreatment and morphological correction post-treatment, grading cleft width, nasal symmetry, and alveolar alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Reliability was evaluated via inter-rater and intrarater agreement using Fleiss \u03ba and quadratic weighted Cohen's \u03ba statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The PAT demonstrated good preliminary inter-rater and intrarater reliability, with inter-rater Fleiss\u2019 \u03ba of 0.83 for pretreatment grading and weighted Cohen's \u03ba of 0.75 for post-treatment grading. Intrarater reliability was substantial to almost perfect (\u03ba\u2009=\u20090.70-0.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PAT demonstrated encouraging preliminary reliability among experienced craniofacial orthodontists evaluating standardized PSIO records. Further multicenter studies are needed to establish broader validity and clinical applicability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261465255","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:18:11Z","timestamp":1782847091000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Reliability Assessment of the Presurgical Infant Orthopedics Assessment Tool for Evaluating Clinical Outcomes of Presurgical Infant Orthopedics"],"prefix":"10.1177","author":[{"given":"Alvaro","family":"Figueroa","sequence":"first","affiliation":[{"name":"Figueroa Orthodontics, Smile Train's Global Medical Advisory Board, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Global Oral Health Programs, Smile Train Organization, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-4235","authenticated-orcid":false,"given":"Puneet","family":"Batra","sequence":"additional","affiliation":[{"name":"Manav Rachna International Institute of Research and Studies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Mejia","sequence":"additional","affiliation":[{"name":"Nicklaus Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6415-1751","authenticated-orcid":false,"given":"Tatiana","family":"Castillo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n de Anomal\u00edas Craneofaciale Fernando Ortiz Monasterio, Instituto Nacional de Pediatr\u00eda INP, M\u00e9xico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Pandan","sequence":"additional","affiliation":[{"name":"Noordhoff Craniofacial Foundation, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Helena Wanderley","family":"Lacerda","sequence":"additional","affiliation":[{"name":"Cleft Lip and Palate Center, Hospital Universit\u00e1rio Lauro Wanderley, Universidade Federal da Para\u00edba, Para\u00edba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2013.00053"},{"key":"e_1_3_2_4_2","volume-title":"Comprehensive Cleft Care","author":"Losee JE","year":"2009","unstructured":"Losee JE, Kirschner RE. Comprehensive Cleft Care. McGraw-Hill; 2009."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000096"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2008.12.005"},{"issue":"4","key":"e_1_3_2_7_2","first-page":"285","article-title":"Congenital oral deformities","volume":"67","author":"McNeil CK","year":"1950","unstructured":"McNeil CK. Congenital oral deformities. Arch Pediatr. 1950;67(4):285-298.","journal-title":"Arch Pediatr"},{"issue":"5","key":"e_1_3_2_8_2","first-page":"687","article-title":"An extraoral force appliance for newborn cleft lip and palate","volume":"66","author":"Latham RA","year":"1980","unstructured":"Latham RA, Kusy RP, Georgiade NG. An extraoral force appliance for newborn cleft lip and palate. 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