Use of the Derriford Appearance Scale 59 to assess patient-reported outcomes in secondary cleft surgery
Notice bibliographique
Résumé
P rimary cleft lip repair often incorporates correction of the cleft noseto reduce the psychosocial consequences of an uncorrected facial difference; however, it does not always eliminate the need for future secondary surgery (1).It is this aspect of cleft lip and/or palate (CLP) facial difference that is most likely to require secondary surgery in early adulthood.The purpose of this surgery is to achieve a more 'normal' nasal appearance by addressing the asymmetry and the stigma associated with CLP.Goals of this surgery are sometimes functional (airway) but are also significantly aesthetic.It alters the individual's facial appearance, and this changes the way in which they perceive themselves, the way they are perceived by others and, therefore, impacts psychological and social well-being (2,3).The method of evaluation of the outcomes of this surgery, with significant aesthetic goals, deserves consideration.Assessment of treatment interventions or surgery has conventionally been performed by physicians.This outcome assessment may include photographic analysis, anatomical measurements and complications.These measures, although important, do not capture the patient's satisfaction -their perception of the result or their healthrelated quality of life (QoL).The patient perspective is particularly relevant in facial reconstructive surgery where the impact on patients' QoL is complex and not necessarily reflected in objective physicianinterpreted outcomes (4,5).Assessing the perspective of a patient with CLP in relation to function, aesthetics and psychosocial well-being should be paramount in measuring surgical outcomes.Patient-reported outcomes (PROs) are concepts that are important to patients with different health conditions.PROs can be measured using purposely designed questionnaires that measure the patient's perspective without interpretation from anyone else.Such measures can capture concepts, such as health-related QoL (a multidomain concept with physical, psychological and social components), and can be used to provide evidence of a treatment benefit from the patient's perspective (6).Many PRO instruments have been used in plastic surgery; however, for a PRO instrument to be scientifically sound it should assess the impact of surgical intervention in a clinically meaningful manner (7).The majority of measures in plastic surgery have not been formally developed in a standardized manner (ie, they have not been tested for reliability [ability to produce consistent scores], validity [ability to measure what is intended to be measured] or responsiveness [ability to measure change]).Reviews of the literature have revealed the lack of a cleft-specific PRO instrument to assess QoL in CLP patients (8,9).In clinical practice, given the lack of a PRO instrument for patients with CLP, generic instruments, or non-disease-specific tools such as the Pediatric Quality of Life Inventory and Child Health Questionnaire have been used as a substitute (10,11).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».