The burden of oral clefting leaves some with psychological problems into adulthood. A new study evaluating the impact of oral clefting on quality of life can be used to learn about the psychological benefits and cost effectiveness of prevention and treatment.
Oral clefting is one of the most common birth defects. The impact of oral clefting can be substantial and can vary by age and type of clefting. Children born with clefts can experience challenging psychological adjustment because of low satisfaction with facial appearance as well as the lack of social skills acquired to enable adjustment. These developmental problems can extend through adulthood, affecting social and economic achievement in areas of marriage, education, and income level.
The study's researchers chose to obtain Health-Related Quality of Life (HRQL) values related to oral clefting based on preferences of health professionals who serve on cleft palate and craniofacial teams in the United States. HRQL is the term used to describe the impact of health status on the quality of human life. It reflects a perception of the undesirability of health or disease conditions, stating their impact on quality of life, which includes physical functioning and comfort level, mental health, and social interactions.
Of the 330 professionals selected for the study, 40% returned the evaluation. Overall, high HRQL values were seen, which suggests a low burden of clefting on individual health and quality of life. However, this contradicts clinical and research evidence and experience that emphasizes the challenges introduced by this defect for all age groups.
Reasons offered by the authors for this contradiction include the following. The evaluators may not have understood the task of the study. Further, it is possible that too few psychologists and behavioral scientists were among the evaluators.
Examples of using the HRQL in the future may include cost-effectiveness analyses of prevention strategies such as vitamin supplementation, or treatment strategies such as prenatal repair of oral clefting. Understanding and obtaining realistic HRQL scores will guide the allocation of health care resources to improve health outcomes overall.