Outcome measures in facial prosthesis research: A systematic review

Abstract

Statement of problem. Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies. Consensus is lacking regarding the most appropriate and meaningful outcome measures to use in facial prosthesis research to capture important perspectives. Purpose. The purpose of the systematic review was to identify and synthesize outcome measures used in facial prosthesis research. Material and methods. Electronic searches were performed in 11 databases (including nonpeer-reviewed literature). The citations were searched, and expert societies were contacted to identify additional studies. Inclusion criteria comprised studies of participants with facial defects who required or had received prosthetic rehabilitation with an external facial prosthesis. Exclusion criteria comprised participants with ocular prostheses, case reports, case series with fewer than 5 participants, laboratory-based studies, and studies published before 1980. Study selection was performed independently by 2 reviewers. Discrepancies were resolved through discussion or by a third reviewer. Outcome measures were synthesized with a categorization approach based on the perspective, theme, and subtheme of the outcome measures. Quality assessment was performed with an appraisal tool that enabled evaluation of studies with diverse designs. Results. Database searching identified 13 058 records, and 7406 remained after duplications were removed. After initial screening, 189 potentially relevant records remained, and 186 full texts were located (98% retrieval rate). After full-text screening, 124 records were excluded. Citation searches and contact with expert societies identified 4 further records. In total, 69 articles (grouped into 65 studies) were included. Studies were categorized as per the perspective of their outcome measures, with the following findings: patient-reported (74% of studies), clinical indicators (34%), clinician-reported (8%), multiple viewpoints (6%), and independent observer-reported (3%). Patient-reported outcome measures included tools to assess satisfaction, quality of life, and psychologic health. Variability in the choice of outcome measures was evident among the studies, with many self-designed, unvalidated, condition-specific questionnaires reported. A greater number of outcome measure themes emerged over time; themes such as service delivery and health state utility have recently been evaluated. Conclusions. Over the past 40 years, facial prosthesis research has focused on patient-reported outcome measures. Outcome measures relating to other perspectives have been used less frequently, although new themes appear to be emerging in the literature. Future research should use outcome measures with appropriate measurement properties for use with facial prosthetics.

Vascularized Composite Allograft Versus Prosthetic for Reconstruction After Facial and Hand Trauma

“…Overall, the available literature indicates favorable long-term outcomes with facial prostheses 3,93,94 . However, significant variability in the choice of outcome measures in these studies makes it challenging to assess objective functional outcomes across studies 95 …”

“…3,93,94 However, significant variability in the choice of outcome measures in these studies makes it challenging to assess objective functional outcomes across studies. 95 Regarding VCA, Lantieri et al 96 reported improvements in quality of life for all 6 face transplant recipients at an average of 6 postoperative years. Sensory and motor recovery reached their final results at 18 months of follow-up, when the orbicularis oris muscle recovery allowed for complete function of the mouth with oral competence.…”

Effects of Brazilian green propolis glycolic solutions against bacterial biofilm on elastomers used in maxillofacial prostheses

“…Over the past 40 years, maxillofacial prosthesis research has concentrated on patient-reported outcome measures. This comprises the lifelong maintenance and replacement of maxillofacial prostheses (Jablonski et al, 2021). The manufacturing of these artificial or alloplastic prostheses with biomaterials permits the reconstruction of lost substance in the head and neck region, thus providing patient rehabilitation and restoring anatomy, function, and esthetics, in addition to social reintegration and improved quality of life (Caxias et al, 2019;Goiato et al, 2009).…”

Maxillofacial prosthetics and digital technologies: Cross‐sectional study of healthcare service provision, patient attitudes, and opinions

“…Changes in facial features can affect patient self-awareness, emotional stability, and personality traits. 1,2 Facial prosthetics are a viable alternative if esthetic and functional demands are not surgically met. [3][4][5] Such prostheses improve patient appearance and their rehabilitation, and reduce surgical and hospital stays and associated costs.…”

“…[6][7][8][9] Consequently, patient's quality of life (QoL), mental health, and satisfaction are significantly enriched. 2 Prosthesis comfort, color, fit, maintenance, aesthetics, cost, and retention efficiency affect patient's opinions and attitudes toward its acceptance or rejection. [10][11][12][13] Their perception is also affected by their rehabilitation journey, construction procedures, clinician confidence, and resource availability.…”