A review of previous studies published in the May/June issue of Archives of Facial Plastic Surgery reports that over the last 10 years, it has become more common to use objective and validated measures for assessing the outcomes of facial plastic surgery.
The literature review, conducted by John S. Rhee, M.D., M.P.H. and Brian T. McMullin, M.D. (Medical College of Wisconsin and the Zablocki Veteran Affairs Medical Center, Milwaukee), spanned over 100 years, consisting of studies published in English between 1806 and 2007. The researchers looked at papers from three broad groups of outcomes studies in the field of facial plastic surgery:
- Patient-reported outcomes studies – focus on patient satisfaction and use a validated or corroborated quality-of-life instrument
- Clinical efficacy outcomes studies – measures the effectiveness of treatments and interventions using objective scales like physician reports
- Actuarial or financial outcomes studies – analyze results relative to various measures of cost
The authors identified and classified the instruments that were used to measure certain facial plastic surgery outcomes as either patient-reported or clinical efficacy measures. The instruments also were placed in categories according to the intervention type, whether they were independently validated, and whether they were used in additional studies.
Rhee and McMullin noted 68 separate instruments – 23 measures that were classified as patient-reported and 45 as clinical efficacy (of which 35 were observer-reported and 10 were objective). “Most patient-reported measures (76 percent) and half of observer-reported instruments (51 percent) were developed in the past 10 years,” the authors write. “The rigor of validation varied widely among measures, with formal validation being most common among the patient-reported outcome measures.”
Using validated measures has become a much more common practice for both physicians and researchers because of the increased attention on improving patient outcomes. “The use of validated tools allows for true comparisons among different interventions or different techniques within a single intervention,” the researchers write. “Such tools can also reliably assist in identifying good surgical candidates and approaches, as well as identifying patients unlikely to benefit from surgery. Finally, they can serve to help demonstrate treatment efficacy and establish legitimacy for third-party payers and government oversight bodies charged with the allocation of resources.”
“Our comprehensive review of the literature for existing outcome measures for an assortment of common facial plastic and reconstructive procedures has revealed a growing abundance of well-constructed and validated outcome measures,” conclude the authors. “However, a wide range in the rigor of validation for some measures and controversy in the universal acceptance of some clinical efficacy measures still remain.”
Outcome Measures in Facial Plastic Surgery: Patient-Reported and Clinical Efficacy Measures
John S. Rhee, MD, MPH; Brian T. McMullin, MD
Archives of Facial Plastic Surgery (2008). 10[3]:194-207.
Written by: Peter M Crosta