Ranganathan Kavitha, Vercler Christian J, Warschausky Seth A, MacEachern Mark P, Buchman Steven R, Waljee Jennifer F
Ann Arbor, Mich. From the Section of Plastic Surgery, Department of Surgery, the Department of Physical Medicine and Rehabilitation, and the Taubman Health Sciences Library, University of Michigan Health System.
Plast Reconstr Surg. 2015 Jan;135(1):198-211. doi: 10.1097/PRS.0000000000000825.
Health care policy makers are increasingly encouraging comparative effectiveness research. Little is known regarding comparative studies among children with cleft lip and/or palate. Cleft lip and/or palate profoundly influences self-perception and social functioning, and patient-reported outcomes provide a unique perspective on the success of reconstruction. The purpose of this study was to systematically review the literature regarding patient-reported outcomes among patients with cleft lip and/or palate.
The authors reviewed articles from MEDLINE, Embase, and PsycInfo that examined the use of patient-reported outcome instruments for cleft lip and/or palate. Studies of patients with cleft lip and/or palate across any age that described the use of patient-completed measures in patient and control populations were included. A research librarian confirmed the search, and two independent, blinded reviewers performed full-text review.
The authors identified 1979 articles and selected 30 for inclusion. Forty-two different assessment tools were used to analyze factors such as self-esteem, behavior, and social support. The Strengths and Difficulties Questionnaire was most commonly used (n = 7), followed by the Childhood Experience Questionnaire (n = 5), and the Satisfaction with Appearance survey (n = 4). Barriers to analysis included lack of standardization of survey administration, effect of publication bias, and variations in patient populations between individual studies.
Comparative studies of patient-reported outcomes among patients with cleft lip and/or palate are infrequent. Many instruments exist to measure patient-reported outcomes in this population, but no specific standard exists. Identifying efficient and targeted forms of instrument selection and administration will enhance comparative studies among children with cleft lip and/or palate.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, III.
医疗保健政策制定者越来越鼓励开展比较效果研究。关于唇腭裂患儿的比较研究知之甚少。唇腭裂会深刻影响自我认知和社交功能，而患者报告的结果为重建手术的成功提供了独特视角。本研究的目的是系统回顾关于唇腭裂患者患者报告结果的文献。
作者检索了MEDLINE、Embase和PsycInfo中检验用于唇腭裂患者报告结果工具使用情况的文章。纳入了任何年龄的唇腭裂患者研究，这些研究描述了在患者和对照人群中使用患者完成的测量方法。一名研究馆员确认了检索结果，两名独立的、不知情的评审员进行了全文评审。
作者识别出1979篇文章，选择了30篇纳入。使用了42种不同的评估工具来分析自尊、行为和社会支持等因素。《长处与困难问卷》使用最为频繁（n = 7），其次是《童年经历问卷》（n = 5）和《外貌满意度调查》（n = 4）。分析的障碍包括调查实施缺乏标准化、发表偏倚的影响以及各研究之间患者人群的差异。
唇腭裂患者患者报告结果的比较研究很少见。有许多工具可用于测量该人群的患者报告结果，但不存在具体标准。确定高效且有针对性的工具选择和实施形式将加强唇腭裂患儿的比较研究。
临床问题/证据水平：诊断性，III级。
