From the Departments of Oral and Maxillofacial Surgery.
Public Health.
Plast Reconstr Surg. 2023 Feb 1;151(2):274e-281e. doi: 10.1097/PRS.0000000000009852. Epub 2022 Nov 10.
To ensure the feasibility of implementing PROMs in clinical practice, they must be continually appraised for undue burden placed on patients and clinicians and their usefulness for decision-making. This study assesses correlations between the CLEFT-Q psychosocial scales in the International Consortium for Health Outcomes Measurement Standard Set for cleft and explores their associations with patient characteristics and psychosocial care referral.
Spearman correlation coefficients were calculated for CLEFT-Q psychological function, social function, school function, face, speech function, and speech-related distress scales. Logistic regressions were used to assess the association of cleft phenotype, syndrome, sex, and adoption status on scale scores and clinical referral to psychosocial care for further evaluation and management.
Data were obtained from 3067 patients with cleft lip and/or palate at three centers. Strong correlations were observed between social function and psychological function (r > 0.69) and school function (r > 0.78) scales. Correlation between school function and psychological function scales was lower (r = 0.59 to 0.68). Genetic syndrome (OR, 2.37; 95% CI, 1.04 to 5.41), psychological function (OR, 0.92; 95% CI, 0.88 to 0.97), school function (OR, 0.94; 95% CI, 0.90 to 0.98), and face (OR, 0.96; 95% CI, 0.94 to 0.98) were significant predictors for referral to psychosocial care.
Because social function as measured by the CLEFT-Q showed strong correlations with both school and psychological function, its additional value for measuring psychosocial function within the Standard Set is limited, and it is reasonable to consider removing this scale from the International Consortium for Health Outcomes Measurement Standard Set for cleft.
为确保患者报告结局（PROMs）在临床实践中的可行性，必须对其给患者和临床医生带来的额外负担以及对决策的有用性进行持续评估。本研究评估了国际健康结局测量联合会（ICHOM）制定的 cleft 量表标准集的 CLEFT-Q 心理社会量表之间的相关性，并探讨了它们与患者特征和心理社会保健转介之间的关联。
计算了 CLEFT-Q 心理功能、社会功能、学校功能、面容、言语功能和言语相关困扰量表之间的斯皮尔曼相关系数。使用逻辑回归评估 cleft 表型、综合征、性别和收养状态对量表评分的影响，以及对心理社会保健的临床转介，以进行进一步评估和管理。
本研究共纳入了来自三个中心的 3067 例唇腭裂患者的数据。社会功能与心理功能（r > 0.69）和学校功能（r > 0.78）量表之间存在较强的相关性。学校功能与心理功能量表之间的相关性较低（r = 0.59 至 0.68）。遗传综合征（OR，2.37；95%CI，1.04 至 5.41）、心理功能（OR，0.92；95%CI，0.88 至 0.97）、学校功能（OR，0.94；95%CI，0.90 至 0.98）和面容（OR，0.96；95%CI，0.94 至 0.98）是转介至心理社会保健的显著预测因子。
由于 CLEFT-Q 测量的社会功能与学校和心理功能均具有较强的相关性，因此其在标准集中测量心理社会功能的额外价值有限，因此可以考虑从国际健康结局测量联合会 cleft 量表标准集中删除该量表。
