Centralization of cleft care in the UK. Part 6: a tale of two studies

Andy R Ness; Andrew K Wills; Andrea E Waylen; Rana Al-Ghatam; Timothy E M Jones; Roger C Preston; A J Ireland; Mia Persson; J Smallridge; Amanda J Hall; D Sell; Jonathan R Sandy

doi:10.1111/ocr.12111

Centralization of cleft care in the UK. Part 6: a tale of two studies

Andy R Ness, Andrew K Wills, Andrea E Waylen, Rana Al-Ghatam, Timothy E M Jones, Roger C Preston, A J Ireland, Mia Persson, J Smallridge, Amanda J Hall, D Sell, Jonathan R Sandy^*

^*Corresponding author for this work

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Abstract

OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG).

SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007.

MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies.

RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure.

CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.

Original language	English
Pages (from-to)	56-62
Number of pages	7
Journal	Orthodontics and Craniofacial Research
Volume	18
Issue number	(Suppl. 2)
DOIs	https://doi.org/10.1111/ocr.12111
Publication status	Published - 16 Nov 2015

Keywords

Cleft Lip
Cleft Palate
Cross-Sectional Studies

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Orthodontics Craniofacial Research part 6
© 2015 The Authors. Orthodontics & Craniofacial Research Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Final published version, 201 KBLicence: CC BY

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title = "Centralization of cleft care in the UK. Part 6: a tale of two studies",

abstract = "OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG).SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007.MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies.RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure.CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.",

keywords = "Cleft Lip, Cleft Palate, Cross-Sectional Studies",

author = "Ness, {Andy R} and Wills, {Andrew K} and Waylen, {Andrea E} and Rana Al-Ghatam and Jones, {Timothy E M} and Preston, {Roger C} and Ireland, {A J} and Mia Persson and J Smallridge and Hall, {Amanda J} and D Sell and Sandy, {Jonathan R}",

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year = "2015",

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day = "16",

doi = "10.1111/ocr.12111",

language = "English",

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T1 - Centralization of cleft care in the UK. Part 6

T2 - a tale of two studies

AU - Ness, Andy R

AU - Wills, Andrew K

AU - Waylen, Andrea E

AU - Al-Ghatam, Rana

AU - Jones, Timothy E M

AU - Preston, Roger C

AU - Ireland, A J

AU - Persson, Mia

AU - Smallridge, J

AU - Hall, Amanda J

AU - Sell, D

AU - Sandy, Jonathan R

PY - 2015/11/16

Y1 - 2015/11/16

N2 - OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG).SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007.MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies.RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure.CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.

AB - OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG).SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007.MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies.RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure.CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.

KW - Cleft Lip

KW - Cleft Palate

KW - Cross-Sectional Studies

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SP - 56

EP - 62

JO - Orthodontics and Craniofacial Research

JF - Orthodontics and Craniofacial Research

IS - (Suppl. 2)

ER -

Centralization of cleft care in the UK. Part 6: a tale of two studies

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