{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:38:10Z","timestamp":1789821490433,"version":"4.0.1"},"reference-count":59,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"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":[[2016,9]]},"abstract":"<jats:p>Nonsyndromic orofacial clefting (OFC) describes a range of phenotypes that represent the most common craniofacial birth defects in humans, with an overall birth prevalence of 1:700 live births. Because of the lifelong negative implications on health and well-being associated with OFC and the numbers of people affected, quality research into its etiology, diagnosis, treatment outcomes, and preventative strategies is essential. A range of different methods is used for recording and classifying OFC subphenotypes, one of which is the International Classification of Diseases (ICD) system. However, there is a general perception that research is being hampered by a lack of sensitivity and specificity in grouping those with OFC into subphenotypes, with potential heterogeneity and confounding in epidemiologic, genetic, and genotype-phenotype correlation studies. This article provides a background to the necessity of OFC research, discusses current controversies within cleft subphenotyping, and provides a brief overview of current OFC classifications as well as their limitations. The LAHSHAL classification is described in the context of a potentially useful tool for OFC that could complement the ICD-10\/ICD-11 Beta coding systems to become a simply understood, universally accepted, clinically friendly, and research-sensitive instrument. Empowering registries, clinicians, and researchers to use a common classification system would have significant implications for OFC research across the world at a time when accurate subphenotyping is crucial and health care research is becoming increasingly tailored toward the individual.<\/jats:p>","DOI":"10.1597\/15-029","type":"journal-article","created":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T18:12:12Z","timestamp":1436897532000},"page":"539-549","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Subphenotyping and Classification of Orofacial Clefts: Need for Orofacial Cleft Subphenotyping Calls for Revised Classification"],"prefix":"10.1177","volume":"53","author":[{"given":"W.A.","family":"Mcbride","sequence":"first","affiliation":[{"name":"Queen's University Dental School, Belfast, Northern Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.T.","family":"Mcintyre","sequence":"additional","affiliation":[{"name":"Consultant of Orthodontics, Dundee Dental Hospital and School, Dundee, Scotland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Royal London Hospital, London, England."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.A.","family":"Mossey","sequence":"additional","affiliation":[{"name":"University of Dundee, Dundee, Scotland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,9,1]]},"reference":[{"issue":"4","key":"bibr1-15-029","first-page":"11","volume":"2","author":"Bernheim N.","year":"2006","journal-title":"B-ENT."},{"key":"bibr2-15-029","doi-asserted-by":"publisher","DOI":"10.1038\/ng.333"},{"key":"bibr3-15-029","doi-asserted-by":"publisher","DOI":"10.1597\/08-061_1"},{"key":"bibr4-15-029","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35526"},{"key":"bibr5-15-029","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199404001-00006"},{"key":"bibr6-15-029","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2007.06.007"},{"key":"bibr7-15-029","first-page":"542078","volume":"2","author":"Carroll K.","year":"2012","journal-title":"Plast Surg Int."},{"key":"bibr8-15-029","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-200011030-00013"},{"key":"bibr9-15-029","first-page":"63","volume":"15","author":"Chosack A.","year":"1978","journal-title":"Cleft Palate J."},{"key":"bibr10-15-029","first-page":"59","volume":"6","author":"Cignini P.","year":"2012","journal-title":"J Prenat Med."},{"key":"bibr11-15-029","doi-asserted-by":"publisher","DOI":"10.1597\/05-0302.1"},{"key":"bibr12-15-029","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2350-13-19"},{"key":"bibr13-15-029","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"bibr14-15-029","doi-asserted-by":"publisher","DOI":"10.1007\/s12663-011-0174-4"},{"key":"bibr15-15-029","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-83242004000200007"},{"key":"bibr16-15-029","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.06.013"},{"key":"bibr17-15-029","doi-asserted-by":"publisher","DOI":"10.1597\/12-261"},{"key":"bibr18-15-029","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2009.069385"},{"key":"bibr19-15-029","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.1998.3021"},{"key":"bibr20-15-029","first-page":"240","volume":"16","author":"Heckler F.R.","year":"1979","journal-title":"Cleft Palate J."},{"key":"bibr21-15-029","first-page":"258","volume":"25","author":"Jensen B.L.","year":"1988","journal-title":"Cleft Palate J."},{"key":"bibr22-15-029","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005385"},{"key":"bibr23-15-029","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197105000-00010"},{"key":"bibr24-15-029","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-195811000-00001"},{"key":"bibr25-15-029","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33695"},{"key":"bibr26-15-029","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2006.tb00211.x"},{"key":"bibr27-15-029","volume-title":"What Is a Cleft Lip and Palate? 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