To establish consensus on definitive, actionable standards for the management of deformational plagiocephaly.
Design
Three-stage Delphi Survey process based on best practice statements obtained through literature review.
Setting
Electronic survey delivery.
Participants
Review panel of 10 multidisciplinary subject matter experts (SMEs); survey panel of 30 cranial orthotists.
Results
Fifty-four best practice statements were accepted in four categories: diagnosis, presentation and severity, initiating treatment, and management principles.
Conclusions
Clinical practice can be guided en route to robust evidence as to the efficacy of various plagiocephaly management strategies, in pursuit of definitive standards.
AnsariS., RashidianA.Guidelines for guidelines: are they up to the task? A comparative assessment of clinical practice guideline development handbooks. PLoS One.2012; 7: e49864. doi: 10.1371/journal.pone.0049864.
2.
BialocerkowskiA.E., VladusicS.L., HowellS.M.Conservative interventions for positional plagiocephaly: a systematic review. Dev Med Child Neurol.2005; 47: 563–570. doi: 10.1017/S0012162205001118.
3.
BialocerkowskiA.E., VladusicS.L., Wei NgC.Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Dev Med Child Neurol.2008; 50: 577–586. doi: 10.1111/j.1469-8749.2008.03029.x.
4.
CollettB., BreigerD., KingD., CunninghamM., SpeltzM.Neurodevelopmental implications of “deformational” plagiocephaly. J Dev Behav Pediatr.2005; 26: 379–389.
5.
FlanneryA.B.K., LoomanW.S., KemperK.Evidence-based care of the child with deformational plagiocephaly, part II: management. J Pediatr Health Care Off Publ Natl Assoc Pediatr Nurse Assoc Pract.2012; 26: 320–331. doi: 10.1016/j.pedhc.2011.10.002.
6.
JacksonR., FederG.Guidelines for clinical guidelines. BMJ.1998; 317: 427–428. doi: 10.1136/bmj.317.7156.427.
LoomanW.S., FlanneryA.B.K.Evidence-based care of the child with deformational plagiocephaly, part I: assessment and diagnosis. J Pediatr Health Care Off Publ Natl Assoc Pediatr Nurse Assoc Pract.2012; 26: 242–250. doi: 10.1016/j.pedhc.2011.10.003.
9.
McGarryA., DixonM.T., GreigR.J.. Head shape measurement standards and cranial orthoses in the treatment of infants with deformational plagiocephaly. Dev Med Child Neurol.2008; 50: 568–576. doi: 10.1111/j.l469-8749.2008.03017.x.
10.
MelnykB.M.Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice.2nd ed.Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins;2011.
11.
RobinsonS., ProctorM.Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr.2009; 3: 284–295. doi: 10.3171/2009.1.PEDS08330.
Van der LindeH., HofstadC.J., van LimbeekJ., PostemaK., GeertzenJ.H.Use of the Delphi technique for developing national clinical guidelines for prescription of lower-limb prostheses. J Rehab Res Dev.2005; 42: 693–704.
14.
WilbrandJ-F, WilbrandM., Pons-KuehnemannJ., BlecherJ.C., ChristophisP., HowaldtH.P., SchaafH.Value and reliability of anthropometric measurements of cranial deformity in early childhood. J Craniomaxillofac Surg.2011; 39: 24–29. doi: 10.1016/j.jcms.2010.03.010.
15.
WoolfS.H., GrolR., HutchinsonA., EcclesM., GrimshawJ.Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines. BMJ.1999; 318: 527–530. doi: 10.1136/bmj.318.7182.527.
