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J Popul Ther Clin Pharmacol. 2014;21(1):e106-13. Epub 2014 Mar 6.

Validation of the facial photographic in fetal alcohol spectrum disorder screening and diagnosis.

Abstract

OBJECTIVE:

A prospective study to validate the computer-assisted method of measuring palpebral fissure length and philtrum smoothness using digital patient photographs. These are key diagnostic facial features of Fetal Alcohol Syndrome.

PARTICIPANTS:

Motherisk Program (including Breaking the Cycle), Hospital for Sick Children, Toronto - a clinical, research and teaching program dedicated to antenatal drug, chemical, and disease risk counseling. 40 children referred for FASD assessment, 21 under 4 years old, 19 were 4 years or older.

METHODS/ MATERIALS:

Facial measurements were obtained directly from the patient by physicians and compared to those obtained by computer software measurement of photographs of the same patient.

OUTCOME MEASURES:

Palpebral fissure length and philtrum smoothness.

RESULTS:

The photographic measurements showed shorter palpebral fissure length than the direct measurements when analyzing all children (25.4±2.3 vs .23.2±2.4mm; p<0.0001), and children under four (n=21, 24.7±2.4 vs. 21.6±1.6mm; p<0.0001). The difference for older children (n=19) did not reach statistical significance. The computer found four false positive cases and no false negative cases of clinically short palpebral fissure (sensitivity=100%, specificity=64%). Direct measurement scores for philtrum smoothness were different from the computer's measurements using the frontal view (p=0.0012) but not using the ¾ view.

CONCLUSION:

The method of computer-assisted measurement tends to underestimate the true length and, hence, over- diagnose short palpebral fissure, especially in children under four years old. This method may serve as a useful fetal alcohol syndrome screening tool.

PMID:
24615428
[Indexed for MEDLINE]

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