Table 2.
Interrater Reliability of Initial Items for the Unilateral Cleft Lip Repair Assessment Tool
| Items | Kappa Coefficient | T Value | Agreement Level | Recommendation | |
|---|---|---|---|---|---|
| Marking a cleft lip repair | |||||
| Correctly identify anatomic landmarks | 0.800 | 2.582* | Substantial | Keep | |
| Mark appropriate peaks of Cupid’s bow on the greater and lesser segments | 0.756 | 3.266* | Substantial | Keep | |
| Design greater segment incision(s) to create a symmetric Cupid’s bow | 1.000 | 3.943* | Almost perfect | Keep | |
| Preserve adequate skin and mucosa to construct a symmetric columella and nasal sill | 0.375 | 1.779† | Fair | Discard | |
| Mark lesser segment incisions to create a symmetric philtral column | 0.400 | 1.291 | Fair | Discard | |
| Preserve excess vermillion on the lesser segment to augment deficient vermillion on the greater segment | 0.583 | 1.845† | Moderate | Keep | |
| Performing a cleft lip repair | |||||
| Precise and accurate incisions | 0.286 | 1.291 | Fair | Discard | |
| Atraumatic tissue handling | 0.600 | 2.070* | Moderate | Keep | |
| Avoid unnecessarily retaining or overresecting tissue | 0.531 | 2.348* | Moderate | Keep | |
| Dissect orbicularis oris muscle and free its abnormal attachments | 0.677 | 2.896* | Substantial | Keep | |
| Inferiorly reposition greater segment so the peaks of Cupid’s bow are symmetric | 0.524 | 2.328* | Moderate | Keep | |
| Fully mobilize the lesser segment lip and alar base | 0.524 | 2.741* | Moderate | Keep | |
| Avoid overdissection or underdissection | 0.667 | 2.843* | Substantial | Keep | |
| Repair the oral mucosa | 0.355 | 1.517 | Fair | Further evaluation needed | |
| Repair the orbicularis oris muscle avoiding deficiency or excess bulk | 0.692 | 3.116* | Substantial | Keep | |
| Close the nasal floor mucosa | 0.545 | 2.463* | Moderate | Keep | |
| Appropriate suture choice and precise cutaneous repair to minimize scarring | 0.552 | 2.782* | Moderate | Keep | |
| Immediate postoperative result | |||||
| Symmetric appearance of the peaks of Cupid’s bow and philtral height | 0.265 | 1.363 | Fair | Further evaluation needed | |
| Continuity of the vermilion–cutaneous junction and white roll | 0.429 | 2.673* | Moderate | Keep | |
| Smooth contour of the lip margin | 0.286 | 1.243 | Fair | Further evaluation needed | |
| Symmetry of the nasal tip, alar position, and nares | 0.623 | 2.923* | Substantial | Keep | |
Grading scale for all question: 1, performed incorrectly or not at all; 2, performed somewhat correctly; 3, performed correctly, acceptable for an attending surgeon.
*P < 0.05 using a 1-tailed test.
†P < 0.05 using a 1-tailed test.