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European Archives of Oto-Rhino-Laryngology

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01-12-2019 | Facial Palsy | Otology

Automated objective and marker-free facial grading using photographs of patients with facial palsy

Authors: Oliver Mothes, Luise Modersohn, Gerd Fabian Volk, Carsten Klingner, Otto W. Witte, Peter Schlattmann, Joachim Denzler, Orlando Guntinas-Lichius

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2019

Abstract

Purpose

An automated, objective, fast and simple classification system for the grading of facial palsy (FP) is lacking.

Methods

An observational single center study was performed. 4572 photographs of 233 patients with unilateral peripheral FP were subjectively rated and automatically analyzed applying a machine learning approach including Supervised Descent Method. This allowed an automated grading of all photographs according to House-Brackmann grading scale (HB), Sunnybrook grading system (SB), and Stennert index (SI).

Results

Median time to first assessment was 6 days after onset. At first examination, the median objective HB, total SB, and total SI were grade 3, 45, and 5, respectively. The best correlation between subjective and objective grading was seen for SB and SI movement score (r = 0.746; r = 0.732, respectively). No agreement was found between subjective and objective HB grading [Test for symmetry 80.61, df = 15, p < 0.001, weighted kappa = − 0.0105; 95% confidence interval (CI) = − 0.0542 to 0.0331; p = 0.6541]. Also no agreement was found between subjective and objective total SI (test for symmetry 166.37, df = 55, p < 0.001) although there was a nonzero weighted kappa = 0.2670; CI 0.2154–0.3186; p < 0.0001). Based on a multinomial logistic regression the probability for higher scores was higher for subjective compared to objective SI (OR 1.608; CI 1.202–2.150; p = 0.0014). The best agreement was seen between subjective and objective SB (ICC = 0.34645).

Conclusions

Automated Sunnybrook grading delivered with fair agreement fast and objective global and regional data on facial motor function for use in clinical routine and clinical trials.

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Title: Automated objective and marker-free facial grading using photographs of patients with facial palsy
Authors: Oliver Mothes
Luise Modersohn
Gerd Fabian Volk
Carsten Klingner
Otto W. Witte
Peter Schlattmann
Joachim Denzler
Orlando Guntinas-Lichius
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keyword: Facial Palsy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 12/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05647-7

At a glance: The STEP trials

Springer Medicine

Automated objective and marker-free facial grading using photographs of patients with facial palsy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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