CLEFT-Q: Detecting Differences in Outcomes among 2434 Patients with Varying Cleft Types

Abstract

Background: Measuring the patient perspective is important in evaluating outcomes of cleft care. Understanding how treatment outcomes vary depending on cleft type may allow for better planning of treatments, setting of expectations, and more accurate benchmarking efforts. The CLEFT-Q is a patient-reported outcome measure for patients with cleft lip and/or palate. Methods: The 12 CLEFT-Q scales measuring appearance (i.e., face, nose, nostrils, lips, cleft lip scar, teeth, and jaws), function (i.e., speech), and health-related quality of life (i.e., psychological, school, social, and speech-related distress) were field tested in a cross-sectional study in 30 centers in 12 countries. Patients with cleft lip and/or cleft palate aged 8 to 29 years were recruited from clinical settings. Differences in CLEFT-Q scores by cleft subtypes were evaluated using one-way analysis of variance or Kruskal-Wallis H tests, with Tukey or Dunn procedure with Bonferroni corrections post hoc analyses, respectively. Scores are presented using radar charts to visualize all outcomes simultaneously. Results: The field test included 2434 patients. Scores on all CLEFT-Q scales varied significantly with cleft subtype. Patients with unilateral or bilateral cleft lip and/or palate scored lower on all appearance scales compared with patients with cleft palate or unilateral incomplete cleft lip. Scores on the speech function and speech-related distress scales decreased with each progressive group in the Veau classification. Patients with complete bilateral cleft lip and palate scored lowest on the social, school, and psychological scales. Conclusions: Patient-reported outcomes measured with the CLEFT-Q vary significantly with cleft type. Visualizing multiple outcomes simultaneously with radar charts allows for an understanding of a patient’s overall status in a single graph.

The Feasibility of Cross-Linguistic Speech Evaluation in the Care of International Cleft Palate Patients

“…It has been demonstrated that participants with less complex cleft types (incomplete uCLP or CP only) have better speech outcomes than those with more complex cleft types (complete uCLP or bCLP). 26 Participants who had speech therapy are also likely have better speech than those who had no therapy. Thus, it is hypothesized that the English SLPs may have had improved accuracy evaluating participants with less severe speech pathology because they did not have to overcome the dual challenges of the unfamiliarity of the language and disordered speech.…”

Impacto dos tratamentos de fissuras labiopalatinas na qualidade de vida: avaliação pelo CLEFT-Q

“…O autorrelato de pacientes com FLP pode variar de acordo com idade, sexo, tipo de fissura (Riff et al, 2019;Klassen et al, 2018) e o tipo de tratamento (Papi et al, 2015;Eckstein et al, 2011) estes achados e indicam o tratamento cirúrgico como modulador da qualidade de vida de pacientes com fissura (Broder et al, 2017;Belluci & Genaro 2016). Estudos evidenciam que os tratamentos das FLP melhoraram significativamente o bem-estar funcional e emocional, a autoestima e interação social, bem como o funcionamento físico e psicológico e, impactam positivamente na condição de saúde bucal de pacientes (Broder et al, 2017;Belluci & Genaro, 2016;Eckstein et al, 2011).…”

Seventy-Fifth Anniversary of Plastic and Reconstructive Surgery: How Evidence-Based Medicine Has Transformed Plastic Surgery

“…Plastic and Reconstructive Surgery has published many articles outlining the development and validation of popular patient-reported outcome measures (Table 3). [50][51][52][53][54][55][56][57][58] One such measure, the BREAST-Q, was used to compare patient satisfaction and quality of life in patients undergoing unilateral and bilateral autologous breast reconstruction. 59 Using an 8-year follow-up, the authors concluded that satisfaction rates did not differ up to 3 years postoperatively; however, a "possible divergence" of satisfaction beyond this time was noted.…”