Conrad J Harrison1, Charlene Rae2, Elena Tsangaris3, Karen W Y Wong Riff4, Marc C Swan5, Tim E E Goodacre6, Stefan Cano7, Anne F Klassen8. 1. Department of Plastic Surgery, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU United Kingdom. 2. Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada. 3. Patient Reported Outcomes Values and Experience Center, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States. 4. Department of Plastic Surgery, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada. 5. Department of Plastic Surgery, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU United Kingdom; Nuffield Department of Surgery, University of Oxford, Room 6607, Level 6, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, United Kingdom. 6. Nuffield Department of Surgery, University of Oxford, Room 6607, Level 6, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, United Kingdom. 7. Modus Outcomes, Suite 210b, Spirella Building, Letchworth Garden City, SG6 4ET, United Kingdom. 8. Department of Pediatrics, McMaster University, Room HSC 3N27, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada. Electronic address: aklass@mcmaster.ca.
Abstract
BACKGROUND: The CLEFT-Q is a patient-reported outcome measure developed for use in patients with cleft lip and/or palate. A significant indicator of the CLEFT-Q's validity relates to its ability to detect differences between the impact of specific aspects of clefting before and after surgery. This study compares relevant sub-scale scores of the CLEFT-Q for patients requiring four specific surgical treatments against those who either have had surgery or never needed surgery. METHODS: CLEFT-Q scores and clinical information regarding the past and future need for jaw surgery, lip revision, rhinoplasty, and speech surgery were obtained from the CLEFT-Q field-test data. Eight one-way analysis of variance (ANOVA) models were developed to compare mean scores of relevant CLEFT-Q scales between those who needed surgery, those who have had surgery, and those who never needed surgery. Only patients from high-income countries were included to minimize the impact of any economic confounders that could result in treatment variation. In the rhinoplasly and lip revision models, patients without a cleft lip were excluded. In the jaw surgery and speech surgery models, patients without a cleft palate or alveolus were excluded. RESULTS: The CLEFT-Q field test included 1938 participants from high-income countries. Participants who needed surgery scored significantly lower (worse) than those who have had surgery in each of the eight relevant CLEFT-Q scales (p < 0.001 in each ANOVA). CONCLUSION: The ability of the CLEFT-Q to detect differences between groups based on surgical status further supports its validity.
BACKGROUND: The CLEFT-Q is a patient-reported outcome measure developed for use in patients with cleft lip and/or palate. A significant indicator of the CLEFT-Q's validity relates to its ability to detect differences between the impact of specific aspects of clefting before and after surgery. This study compares relevant sub-scale scores of the CLEFT-Q for patients requiring four specific surgical treatments against those who either have had surgery or never needed surgery. METHODS: CLEFT-Q scores and clinical information regarding the past and future need for jaw surgery, lip revision, rhinoplasty, and speech surgery were obtained from the CLEFT-Q field-test data. Eight one-way analysis of variance (ANOVA) models were developed to compare mean scores of relevant CLEFT-Q scales between those who needed surgery, those who have had surgery, and those who never needed surgery. Only patients from high-income countries were included to minimize the impact of any economic confounders that could result in treatment variation. In the rhinoplasly and lip revision models, patients without a cleft lip were excluded. In the jaw surgery and speech surgery models, patients without a cleft palate or alveolus were excluded. RESULTS: The CLEFT-Q field test included 1938 participants from high-income countries. Participants who needed surgery scored significantly lower (worse) than those who have had surgery in each of the eight relevant CLEFT-Q scales (p < 0.001 in each ANOVA). CONCLUSION: The ability of the CLEFT-Q to detect differences between groups based on surgical status further supports its validity.
Authors: Conrad J Harrison; Chris J Sidey-Gibbons; Anne F Klassen; Karen W Y Wong Riff; Dominic Furniss; Marc C Swan; Jeremy N Rodrigues Journal: Plast Reconstr Surg Glob Open Date: 2021-09-17