The Whitaker Classification of Craniosynostosis Outcomes: An Assessment of Inter-Rater Reliability.

Purpose: The Whitaker classification (WC) is a simple and widely used system for describing aesthetic outcomes after craniosynostosis surgery. The purpose of this study is to evaluate its inter-rater reliability for patients who have undergone frontal-orbital surgery. Methods: A retrospective review of patients with craniosynostosis who underwent surgical intervention at a tertiary referral center was conducted. Inclusion criteria were: single-suture craniosynostosis, surgical intervention before age two years, and photographs taken prior to revisions between 5 and 20 years of age. Thirteen craniofacial surgeons independently reviewed the subject's photographs and assigned WC. Inter-rater reliability was assessed with Cohen's kappa. Results: Twenty-nine subjects were included. Average ages at surgery and the time of post-operative photographs were 0.8 years, and 12.8 years, respectively. The [kappa] value for all 13 raters was 0.1567 (p

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