Refining Measures of Lip Function

描述（由申请人提供）：本R 03的目标是对现有面部/唇部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唇修复手术的结局;包括动态面部运动、唇力、唇部感觉和感觉整合功能的测量。个体测量提供了面部/唇部损伤的客观评估，外科医生可以在唇腭裂患者唇翻修的决策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R 03中，将对这些措施采用统计方法，以实现以下具体目标。具体目标1-从单独的功能测量中生成唇部损伤的复合统计测量。将探讨不同的措施组合，以产生一组措施，更完整地表征面部功能问题或损伤。具体目标2-适应当前，并开发新的，统计方法的建模动态面部运动的新应用，并分析预测变量，运动速度和补偿运动方面的运动变化。待检验的假设如下：（1）复合测量提供了面部损伤分析的更高灵敏度，并且（a）更准确地区分唇裂患者和非唇裂受试者，以及（B）更准确地量化唇裂患者接受唇部矫正手术后面部损伤的变化;以及（2）当前统计技术的适应和新统计技术的发展可以根据受试者预测变量（例如，唇裂与无唇裂;单侧与双侧唇裂等）、运动速度以及适合于特定研究对象的补偿运动。这项研究的影响将是完善目前的减值措施和面部/唇损伤的综合措施，包括个人措施之间的相互关系和信息的发展。所开发的措施将在表征手术治疗的现有和未来结局方面提供巨大优势。

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.