Refining Measures of Lip Function

描述(申请人提供)：本R03的目标是对现有的面部/嘴唇功能测量数据库进行二次分析。这些数据是在一项正在进行的、由NIDCR资助的前瞻性非随机对照临床试验中收集的，该试验旨在评估唇裂儿童的唇部翻修手术的结果；包括动态面部运动、唇力、嘴唇感觉和感觉整合功能的测量。这些个别措施提供了面部/嘴唇损伤的客观评估，外科医生可以在决定支持或反对唇裂患者进行唇部翻修的过程中使用这些评估，并确定哪些患者将从翻修手术中受益。在本R03中，统计方法将应用于这些措施，以解决以下具体目标。具体目标1-从单个功能测量生成嘴唇损伤的综合统计测量。将探索不同的测量组合，以产生一套更全面地表征面部功能问题或损伤的测量方法。具体目标2-适应当前的统计方法，并开发新的统计方法来模拟动态面部运动的新应用，并根据预测变量、运动速度和补偿运动来分析运动的变化。将接受检验的假设如下：(1)综合测量提供了更高的面部损伤分析灵敏度，(A)更准确地区分唇裂患者和非唇裂患者，以及(B)更准确地量化唇裂修复术患者面部损伤的变化；以及(2)对现有技术的适应，以及新的统计技术的发展，可以根据受试者预测变量(例如，唇裂与非唇裂；单侧与双侧唇裂等)、运动速度以及适合特定研究对象的代偿运动来表征面部运动。这项研究的影响将是改进目前的损害措施，并开发一种面部/嘴唇损害的综合衡量标准，其中包括各个衡量标准之间的相互关系和信息。开发的测量方法(S)将在表征外科治疗的现有和未来结果方面提供巨大的优势。

DESCRIPTION (provided by applicant): The goal of this R03 is to conduct secondary analyses on an existing database of facial/lip functional measures. The data was collected during an on-going, NIDCR-funded, prospective non-randomized controlled clinical trial to assess outcomes of lip revision surgery in children with a cleft lip; and consists of measures of dynamic facial movement, lip force, lip sensation, and sensory-integrative function. The individual measures provide an objective assessment of facial/lip impairment that can be used by surgeons in the decision-making process for or against lip revision in cleft patients, and in the determination of which patients would benefit from revision surgery. In this R03, statistical approaches will be applied to these measures to address the following specific aims. Specific Aim 1-Generate composite statistical measures of lip impairment from the individual functional measures. Different combinations of measures will be explored in order to produce a set of measures that more completely characterizes facial functional problems or impairment. Specific Aim 2-To adapt current, and develop new, statistical approaches to the novel application of modeling dynamic facial movement and to analyze variation in movement in terms of predictor variables, movement velocity, and compensatory movements. The hypotheses to be tested are as follows: (1) Composite measures provide a greater sensitivity of analysis of facial impairment and (a) more accurately discriminate between patients with cleft lip and non-cleft subjects, and (b) more accurately quantify the change in facial impairment in patients with cleft lip who have lip revision surgery; and (2) Adaptations of current, and the development of new, statistical techniques can characterize facial movement in terms of subject predictor variables (e.g., cleft lip versus no cleft; unilateral versus bilateral cleft lip, etc), velocity of movement, and compensatory movements appropriate for the particular subject of study. The impact of this research will be the refinement of the current impairment measures and the development of a composite measure of facial/lip impairment that encompasses the interrelationships and information among the individual measures. The developed measure(s) will provide a tremendous advantage in terms of characterizing existing and future outcomes for surgical treatment.