Applied Online Crowdsourcing in Plastic and Reconstructive Surgery

Suchyta, Marissa; Azad, Amee D.; Patel, Ashraf A.; Khosla, Rohit K.; Lorenz, H. Peter; Nazerali, Rahim

doi:10.1097/sap.0000000000002389

Cited by 20 publications

(14 citation statements)

References 19 publications

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“…Forty-five articles were ultimately included for data extraction (Table 1). 13–57 Proportionate rater agreement was 91.7% for abstract screening and 92.5% for full-text screening. The Cohen kappa coefficient for interrater reliability was 0.82 for abstract screening and 0.81 for full-text screening, demonstrating sufficient interrater reliability.…”

Section: Resultsmentioning

confidence: 99%

Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations

Villavisanis

Blum

Cheung

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Crowdsourcing uses online platforms to collect large data from laypersons and has been increasingly used over the past 5 years to answer questions about aesthetic and functional outcomes following plastic and reconstructive surgery. This systematic review evaluates crowdsourcing articles in plastic and reconstructive surgery based on study topic, participants, and effect size in the hopes of describing best practices. Methods: A systematic search strategy was developed with a licensed librarian and attending plastic surgeon to query all articles using crowdsourcing in plastic and reconstructive surgery. Covidence systematic review manager was used by two independent reviewers to import articles, screen abstracts, evaluate full texts, and extract data. Results: A search run on October 8, 2021, yielded 168 studies, of which 45 were ultimately included. Craniofacial surgery and aesthetic surgery collectively constituted over half of studies. Participants in plastic surgery crowdsourcing studies are more commonly from the United States, female, straight, 25 to 35 years old; have completed college; and earn $20,000 to $50,000 per year. Studies typically assessed aesthetic perceptions, cost approximately $350, ran a median of 9 days, included approximately 60 unique survey items, and included approximately 40 unique human images. Conclusions: Crowdsourcing is a relatively new, low-cost method of garnering high-volume data from laypersons that may further our understanding of public perception in plastic and reconstructive surgery. As with other nascent fields, there is significant variability in number of subjects used, subject compensation, and methodology, indicating an opportunity for quality improvement.

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Section: Resultsmentioning

confidence: 99%

Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations

Villavisanis

Blum

Cheung

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

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“…Studies aiming to assess layperson opinion on surgical outcomes are commonly prone to recruitment difficulty and selection bias by geographic location or study pool [24,25]. As a result, the utilization of online crowdsourcing, specifically Amazon's Mechanical Turk (MTurk), in research has drastically increased as it offers the unique potential to efficiently recruit large numbers of layperson respondents to assess public perception [26].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…As a result, the utilization of online crowdsourcing, specifically Amazon's Mechanical Turk (MTurk), in research has drastically increased as it offers the unique potential to efficiently recruit large numbers of layperson respondents to assess public perception [26]. Furthermore, MTurk is specifically helpful in answering aesthetic questions such as "which size looks bigger" or "which belly button shape is nicer" as it offers a reduction in selection bias, ease of study design, and enhanced efficiency of large-scale participant recruitment [24]. This study aims to examine and quantify the aesthetic impacts of unilateral radiation on subsequent bilateral deep inferior epigastric perforator (DIEP) flap reconstruction by surveying both plastic survey experts and layperson volunteers through MTurk.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…26 Furthermore, MTurk is specifically helpful in answering aesthetic questions such as "which size looks bigger" or "which belly button shape is nicer" as it offers a reduction in selection bias, ease of study design, and enhanced efficiency of large-scale participant recruitment. 24 This study aims to examine and quantify the aesthetic impacts of unilateral radiation on subsequent bilateral deep inferior epigastric perforator (DIEP) flap reconstruction by surveying both plastic survey experts and layperson volunteers through MTurk. We hypothesized that the free flap in a radiated skin envelope appears smaller than the contralateral, unirradiated side, leading to asymmetry and an overall perceived suboptimal aesthetic result by both expert and layperson volunteers.…”

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confidence: 99%

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Visual Perception of Breast Free Flap Size Is Influenced by Radiation Changes of Surrounding Tissue

Wang

Rothchild

et al. 2023

J Reconstr Microsurg

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Introduction: Microsurgical reconstruction for bilateral mastectomy defects after unilateral radiation often results in asymmetry, despite both flap tissues never being radiated. Methods: Photos of 16 patients who received prior radiation to one breast and underwent bilateral abdominal free flap reconstruction were taken postoperatively. Layperson and expert assessment of were attained via online crowdsourcing and a panel of attending surgeons and senior residents. Stratified by inter-flap weight differences was done for sub-analysis. Results: A totally of 399 laypersons responded with the majority (57.3%) reporting that the radiated breast appeared smaller than the non-radiated breast. When the photos were stratified by inter-flap weight differences, the photos with the radiated side flap weight over 3% more than nonradiated side were significantly more likely to be perceived by laypersons as the same size (OR=2.7, p < 0.001) and of similar aesthetic (OR = 1.9, p < 0.001) when compared with photos with same-sized flaps. Of the expert responses (n=16), the radiated side was perceived as smaller 72.3% of the time and the nonradiated side appeared more aesthetic 52.7% of the time. Contrary to layperson responses, the experts tend to report the radiated side as smaller despite varying flap weight. Interestingly, expert raters were significantly more likely to rate the flaps of equal aesthetics when the radiated side has a flap larger by 3% or more (OR=3.6, p<0.001). Conclusion: Higher aesthetic scores were noted when larger flaps were inset to the radiated envelope by both laypersons and experts, suggesting potential technical refinement in reconstructive outcomes.

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“…Platforms such as Amazon Mechanical Turk (MTurk), have previously investigated the concordance of layperson crowdsourced worker ratings with ratings of experts in the domains of cleft speech and Asher-McDade fixed-scale ratings, [8][9][10] and used MTurk to compare aesthetic outcomes in cleft lip repair. 11,12 Encouraged by the results of these studies, which found that online crowdsourced ratings are highly consistent with expert opinion, we aim to understand lay perspective of cleft outcomes using a novel technique of simulating different lip angles and scar thicknesses.…”

mentioning

confidence: 99%

Seeing Cleft Lip from a New Angle: Crowdsourcing to Determine Whether Scar Severity or Lip Angle Matters More to the General Public

Sescleifer

Francoisse

Osborn

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Cleft lip-nose-palate is the most common surgical congenital difference, with an incidence of one in 600 live births. 1,2 Orofacial clefts are physically stigmatizing, with important psychosocial consequences for a developing child. 3 In unilateral cleft lip, there is significant mismatch in the vermilion and philtrum, including asymmetry of the Cupid's bow peaks. Plastic surgeons strive to restore normal facial appearance: one of the main goals of modern cleft lip repair is to "balance" the Cupid's bow peaks, to create a level, even, normal-appearing Cupid's bow (Fig. 1). 4-6 If Cupid's bow peaks are uneven, the resulting angle disrupts facial symmetry and may make the upper lip appear unbalanced. Therefore, the plastic surgeon's intraoperative focus is crafting as symmetric and level of a lip as possible; however, our team noticed that families rarely mention lip angle, and instead are concerned with the degree of postsurgical scarring.Background: Modern cleft lip surgery aims to restore symmetry and create a level, normal-appearing Cupid's bow. However, families' concerns often center on the degree of scarring. The authors hypothesized that the lip angle would be less influential than scar severity in layperson ratings. Methods: The authors received institutional review board approval for modifying patients' postoperative photographs to create systematic variations displaying different levels of scarring and lip angle. Each child's resulting composite images were presented in pairs to internet raters using Amazon Mechanical Turk. Users selected the simulated postoperative result they felt to be most normal. The Bradley-Terry model was used to determine raters' preferences between different levels of scarring and lip angle. Results: Four children with primary unilateral cleft lip repair had their postoperative photographs modified (mean age, 1.4 years; mean follow-up, 1.0 years). Twelve-hundred crowdsourced pairwise ratings were collected for each patient (4800 combined ratings). For all four children, raters preferred images with more severe scarring than those with a greater lip angle, suggesting uneven lip angle has a more negative effect on perceived appearance. Conclusions: Online crowdsourcing postoperative lip angle had a significantly greater influence on ratings of normal appearance than does the severity of scarring. Although patients may ask about scars more often, clinically, this study suggests perceptions of a cleft lip repair result may be more likely influenced by the angle of the cleft lip repair.

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Applied Online Crowdsourcing in Plastic and Reconstructive Surgery

Cited by 20 publications

References 19 publications

Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations

Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations

Visual Perception of Breast Free Flap Size Is Influenced by Radiation Changes of Surrounding Tissue

Seeing Cleft Lip from a New Angle: Crowdsourcing to Determine Whether Scar Severity or Lip Angle Matters More to the General Public

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