Cross-Cultural Validation and Application of the Thai CLEFT-Q in Assessing Patient-Reported Outcomes for Cleft Lip and Palate

Abstract

This study evaluated the cross-cultural validity of the CLEFT-Q and measured patient satisfaction with surgical outcomes among patients with cleft lip and/or palate. Conducted as a Phase 2 study at a tertiary referral hospital in Thailand, the research involved 93 patients aged 8 to 29 years who had undergone cleft lip and/or cleft palate surgery. Participants completed the CLEFT-Q, a patient-reported outcome measure, to assess their satisfaction with appearance, health-related quality of life, and facial function. The comprehensibility of the CLEFT-Q was also evaluated. Rasch-transformed scores were analyzed, with statistical significance set at P≤0.05. Results showed moderate satisfaction with appearance (mean=53.8), with the highest scores for jaw appearance and the lowest for nostrils, teeth, and cleft scars. In contrast, satisfaction with facial function was higher (mean=70.9), and psychosocial and speech-related outcomes were favorable. The CLEFT-Q demonstrated high comprehensibility across all domains. The study concludes that the CLEFT-Q is a valid tool for assessing patient-reported outcomes in Thailand. While functional outcomes are generally positive, aesthetic satisfaction - particularly regarding nasal and dental appearance - requires further improvement. These findings highlight the importance of a greater emphasis on aesthetic outcomes in cleft care to more effectively meet patient expectations.