Citron Isabelle, Ganske Ingrid, Massenburg Benjamin B, Doyle Michael, Meara John G, Rogers-Vizena Carolyn R
Department of Plastic and Oral Surgery, Boston Children's Hospital, and Harvard Medical School, Boston, Mass.
Division of Plastic Surgery, University of Washington, Seattle, Wash.
Plast Reconstr Surg Glob Open. 2018 Aug 16;6(8):e1894. doi: 10.1097/GOX.0000000000001894. eCollection 2018 Aug.
The International Consortium for Healthcare Outcomes Measurement recently published a consensus Standard Set of clinical and patient-centered metrics to measure outcomes for patients with cleft lip and/or palate (CLP). This study aims to evaluate how the Standard Set compares to existing data collected to anticipate the impact that the Standard Set may have on quality and quantity of outcome data.
Extraction of the Standard Set data points was attempted retrospectively for all nonsyndromic patients with bilateral cleft lip and/or palate who underwent primary lip and/or palate repair by a single surgeon (JGM) between June 2007 and June 2014.
Bilateral cleft lip repair was performed on 32 patients of which 29 also underwent palate repair. All but one of the baseline demographic and phenotypic variables were available. All perioperative variables were collected, but data quality was heterogeneous. There were no early complications. At 5 years, 29.6% of patients were lost to follow-up; however, a degree of data was available on 11 of the 12 clinical metrics for those remaining. Of patients with Veau IV cleft palate and follow-up at age 5, 1 patient (6.7%) had an oronasal fistula and 1 had velopharyngeal incompetence requiring Furlow palatoplasty (6.7%). No patient-reported data were collected for any time point.
Prospective collection of the International Consortium for Healthcare Outcomes Measurement Standard Set will improve consistency of clinical data and add the patient perspective currently lacking in outcome measures collected for patients with bilateral cleft.
国际医疗保健成果测量联盟最近发布了一套关于唇腭裂(CLP)患者临床和以患者为中心指标的共识标准集,旨在衡量其治疗效果。本研究旨在评估该标准集与现有收集数据的对比情况,以预测该标准集可能对治疗效果数据的质量和数量产生的影响。
对2007年6月至2014年6月间由同一位外科医生(JGM)进行一期唇和/或腭裂修复的所有非综合征性双侧唇腭裂患者,尝试回顾性提取标准集数据点。
对32例患者进行了双侧唇裂修复,其中29例还接受了腭裂修复。除一项外,所有基线人口统计学和表型变量均可得。所有围手术期变量均已收集,但数据质量参差不齐。无早期并发症。5岁时,29.6%的患者失访;然而,对于剩余患者,12项临床指标中的11项有一定程度的数据可用。在5岁接受随访的伴有IV度腭裂的患者中,1例(6.7%)出现口鼻瘘,1例出现腭咽功能不全,需要进行Furlow腭成形术(6.7%)。未在任何时间点收集患者报告的数据。
前瞻性收集国际医疗保健成果测量联盟标准集将提高临床数据的一致性,并增加目前双侧腭裂患者治疗效果测量中所缺乏的患者视角。