Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate.

Autor:	Del Risco AC; From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C., Dunworth K; From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C., Sharif-Askary B; From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C., Suárez AHB; Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C., Nyswonger J; Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C., Ford M; Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C., Kern J; Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C., Jones C; Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, N.C.; Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C., Raynor E; From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C.; Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C.; Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, N.C., Allori AC; From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C.; Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, N.C.; Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Jan 19; Vol. 12 (1), pp. e5519. Date of Electronic Publication: 2024 Jan 19 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005519
Abstrakt:	Background: The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal competency rating (VPC-R). This study explores the utility and limitations of these generic measures in detecting cleft speech sound disorders by comparing them with two cleft-specific speech-rating systems, cleft audit protocol of speech-augmented Americleft modification (CAPS-A-AM) and Pittsburgh weighted speech scale (PWSS). Methods: Consecutive children with repaired, nonsyndromic cleft lip/palate, aged 5 years or older (n = 27) underwent prospective speech evaluations conducted at a single academic institution. These evaluations were conducted, recorded, and evaluated by blinded speech-language pathologists experienced with all tools. Results: When comparing measures of articulation, PCC scores correlated better with scores for relevant subcomponents of CAPS-A-AM than PWSS. When comparing measures of velopharyngeal function, VPC-R scores correlated well with relevant components of both scales. Using a "screening test versus diagnostic test" analogy, VPC-R ratings were 87.5% sensitive and 73.7% specific for detecting velopharyngeal dysfunction according to subcomponents of CAPS-A-AM, and 70.6% sensitive and 100% specific according to subcomponents of PWSS. Conclusions: This exploratory study demonstrates that PCC and VPC-R perform moderately well in detecting articulatory and velopharyngeal dysfunction in patients with cleft lip/palate; however, these tools cannot describe nuances of cleft speech sound disorder. Thus, although PCC and VPC-R adequately track basic minimum outcomes, we encourage teams to consider extending the standard set by adopting a cleft-specific measurement system for further evaluation of the tools. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. Del Risco was supported by a National Institutes of Health R25 grant (1R25DC020172-01). (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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