Outcomes Research and Facial Plastic Surgery

ABSTRACT

Outcomes research examines the delivery of medical care from the patient's perspective, using unique instruments and methodologies. Outcome studies can measure the effectiveness of treatments or interventions in individual patients or in large populations, using prospective observational research designs. The steps in performing outcomes research are as follows: identify and define the disease or procedure of interest, create a staging system for disease severity, identify important co-morbid conditions, choose or design an outcomes instrument to measure treatment outcomes, and design a study to assess outcomes prospectively. Although there is currently a dearth of outcomes instruments available for use in facial plastic and reconstructive surgery, some new instruments are being developed, and even using existing tools outcomes research should prove to be a valuable research tool for facial plastic surgeons to demonstrate improved quality of life and functional status in their patients.

KEYWORDS

Outcomes research - facial plastic surgery

REFERENCES

• 1 Piccirillo J F, Stewart M G, Gliklich R E, Yueh B. Outcomes research primer.  Otolaryngol Head Neck Surg . 1997;  117 380-387
• 2 Ellwood P M. Shattuck lecture-outcomes management: a technology and patient experience.  N Engl J Med . 1988;  318 1549-1556
• 3 Health Outcomes Research: Health Outcomes Research: A Primer Washington, DC: Foundation for Health Services Research. 1993
• 4 Stewart M G. Patient-based outcomes research. In: Rosenfeld RM Bluestone C eds. Evidence-Based Otitis Media Hamilton ON:BC Decker 1999: 51-60
• 5 Piccirillo J F. Outcomes research in otolaryngology.  Otolaryngol Head Neck Surg . 1994;  111 764-769
• 6 Cella D F, Bonomi A E. Measuring quality of life: 1995 update.  Oncology . 1995;  47-60
• 7 Gill T M, Feinstein A R. A critical appraisal of the quality of quality-of-life measurements.  JAMA . 1994;  272 619-626
• 8 Aday L. Designing and Conducting Health Surveys 2nd ed.  San Francisco: Jossey-Bass 1996
• 9 DeVellis R. Scale Development: Theory Applications .  Newbury Park CA: Sage 1991
• 10 Lipsey M W. Design Sensitivity: Statistical Power for Experimental Research .  Newbury Park CA: Sage 1990
• 11 Litwin M S. How to Measure Survey Reliability Validity.  Thousand Oaks CA: Sage 1995
• 12 Alsarraf R. Outcomes research in facial plastic surgery: a review new directions.  Aesth Plast Surg . 2000;  24 192-197
• 13 Stewart M G. Outcomes research in oral cavity reconstruction. In: Day T Girod DA eds. Soft Tissue Reconstruction of the Oral Cavity New York: Marcel Dekker 2001 in press
• 14 Alsarraf R, Larrabee W F, Anderson S, Murakami C S, Johnson C M. Measuring cosmetic facial plastic surgery outcomes: a pilot study.  Arch Facial Plast Surg . 2001;  3 198-201
• 15 Patrick D L, Deyo R A. Generic disease-specific measures in assessing health status and quality of life.  Med Care . 1989;  27 S217-S232
• 16 Gonella J S, Hornbrook M C, Louis D Z. Staging of disease: a case-mix measurement.  JAMA . 1984;  251 637-644
• 17 Snyderman C H, Wagner R L. Superiority of the T N integer score (TANIS) staging system for squamous cell carcinoma of the oral cavity.  Otolaryngol Head Neck Surg . 1995;  112 691-694
• 18 Piccirillo J F, Wells C K, Sasaki C T. New clinical severity staging system for cancer of the larynx.  Ann Otol Rhinol Laryngol . 1994;  103 83-92
• 19 Feinstein A R. The pre-therapeutic classification of co-morbidity in chronic disease.  J Chron Dis . 1970;  23 455-468
• 20 Piccirillo J F. Inclusion of comorbidity in a staging system for head and neck cancer.  Oncology . 1995;  9 831-836
• 21 Wilkins E G, Lowery J C, Smith Jr J D. Outcomes research: a primer for plastic surgeons.  Ann Plast Surg . 1996;  37 1-11
• 22 Alsarraf R, Larrabee W F, Johnson C M. Cost outcomes of facial plastic surgery: regional and temporal trends.  Arch Facial Plast Surg . 2001;  3 44-47
• 23 Klassen A, Jenkinson C, Fitzpatrick R, Goodacre T. Patients' health related quality of life before and after aesthetic surgery.  Br J Plast Surg . 1996;  49 433-438
• 24 Rankin M, Borah G L, Perry A W, Wey P D. Quality-of-life outcomes after cosmetic surgery.  Plast Reconstr Surg . 1998;  102 2139-2145
• 25 Coady M S. Measuring outcomes in plastic surgery.  Br J Plast Surg . 1997;  50 200-205
• 26 Luce E A. Outcome studies and practice guidelines in plastic surgery.  Plast Recontr Surg . 1999;  104 1187-1190
• 27 Fitzpatrick R, Jenkinson C, Klassen A, Goodacre T. Methods of assessing health-related quality of life and outcome for plastic surgery.  Br J Plast Surg . 1999;  52 251-255
• 28 Cole R P, Shakespeare V, Shakespeare P, Hobby J A. Measuring outcome in low-priority plastic surgery patients using quality of life indices.  Br J Plast Surg . 1994;  47 117-121
• 29 Klassen A, Jenkinson C, Fitzpatrick R, Goodacre T. Measuring quality of life in cosmetic surgery patients with a condition-specific instrument: the Derriford scale.  Br J Plast Surg . 1998;  51 380-384
• 30 Harris D L, Carr A T. The Derriford appearance scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance.  Br J Plast Surg . 2001;  54 216-222
• 31 Klassen A, Fitzpatrick R, Jenkinson C, Goodacre T. Contrasting evidence of the effectiveness of cosmetic surgery from two health related quality of life measure.  J Epidemiol Commun Health . 1999;  53 440-441