Outcome assessment in cleft lip and palate surgery
Outcome assessment for cleft management is complex due to the diverse elements of function affected by the condition, and the variation in effect on patients over time. Methods of assessment are broadly separated into objectively measurable variables that can be independently validated, and patient-reported measures that are necessarily more subjective. Validated tools to evaluate outcomes are now widely adopted for speech and facial growth, with other areas of outcome presenting greater problems in development of suitable measures. In recent years, the emphasis of outcome evaluation has turned towards greater reliance on patient-reported measures that require extensive preliminary research to develop if a high degree of validity is to be ensured. Existing outcome measures that are widely used are described in this chapter, along with a perspective for future trends and a forthcoming internationally applicable tool for comparative studies (ICHOM).