How Does CLEFT-Q Change the Way We Practice? A Prospective Study Integrating Patient-Reported Outcomes.

Autor:	Salinero LK; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Cheung L; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Villavisanis DF; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Wagner CS; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Barrero CE; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Pontell ME; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Jackson OA; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Taylor JA; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Low DW; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia., Swanson JW; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Nov 01; Vol. 154 (5), pp. 1037-1045. Date of Electronic Publication: 2023 Sep 01.
DOI:	10.1097/PRS.0000000000011036
Abstrakt:	Background: The CLEFT-Q is a validated instrument designed to elicit patient-reported outcomes among people affected by cleft lip and/or palate. However, it has not been reported how use of CLEFT-Q data alters routine cleft care. This study analyzed the impact of CLEFT-Q data integration on patient care and clinical decision-making. Methods: Patients were sequentially, prospectively evaluated during scheduled cleft team visits. The CLEFT-Q was completed before the clinic encounter, but results were initially masked from the surgeon and family. In the encounter, a study observer characterized patients' verbalized attitudes across 7 specific domains of appearance and function, and the provisional assessment and plan was noted. CLEFT-Q data were then introduced into the clinical encounter and discussed. Discordance between patients' initially verbalized attitudes and their self-reported scores on the CLEFT-Q was documented along with any resultant modifications to their care plan. Results: Seventy patient visits were observed; the mean patient age was 12.7 years (range, 8 to 19 years). Forty-one patients (59%) had cleft lip and palate/alveolus and 29 (41%) had isolated cleft palate. Discordance was observed in 36% of visits and in 9.2% of specific domains assessed. Highest discordance rates were observed in domains of psychosocial function (12.5%), speech function/distress (11.6%), and lips/lip scar appearance (11.6%). No age group or sex was associated with increased discordance. Integration of CLEFT-Q results altered the assessment and plan in 11 visits (16%). Conclusion: The CLEFT-Q provides clinically relevant insight into patient perspectives that are not captured by routine interview and examination alone, and regularly leads to a change in the management plan. (Copyright © 2023 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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