Facial imaging to screen for foetal alcohol spectrum disorder (FASD): A scoping review

Roomaney, I., Nyirenda, C. and Chetty, M. (2022), Facial imaging to screen for foetal alcohol spectrum disorder (FASD): A scoping review. Alcohol Clin Exp Res. Accepted Author Manuscript. https://doi.org/10.1111/acer.14875



Facial imaging tools have rapidly advanced in recent years and show potential to be used for Foetal Alcohol Spectrum Disorder (FASD) screening and diagnosis. This scoping review aimed to determine the current state of evidence regarding facial imaging being used as a screening tool for FASD at a community level.


This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) guidelines and is registered with the Open Science Framework (OSF) (osf.io/e4xw6). An electronic search of five databases was conducted. The time frame was limited from 2006 to 2022. The search included any form of imaging of the head, neck, oral cavity, and dentition. Animal, antenatal and studies using only brain imaging were excluded.


The search retrieved 730 unique titles. After title, abstract and full-text screening, 28 primary studies were included in this review. A majority of studies was conducted with South African participants. Imaging included 2D photographs, 3D stereophotogrammetry, 3D laser scanning and radiographs. Various measurements and landmarks were used to discriminate FASD from non-FASD participants, which included anthropometry, face shape analysis, and facial curvatures. Methods of data processing, analysis and modelling ranged from manual methods to fully automated systems utilising artificial intelligence.


The use of facial imaging to screen for and diagnose patients with FASD is a rapidly advancing field. Most studies in the field remain exploratory, attempting to find accurate, reliable, and consistent landmarks and measures across different populations. For community screening, none of the tools in this review completely fulfil all the identified properties of an ideal screening tool in their current form. More research and development are needed prior to advocating for any tool listed and the ethical implications are yet to be fully explored.

Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.14875

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