title: Outcome measures in facial plastic surgery: patient-reported and clinical efficacy measures.
abstract: OBJECTIVE
  To survey the existing literature to identify, summarize, and evaluate procedure- and condition-specific outcome measures for use in facial plastic and reconstructive surgery.
  
  
  METHODS
  A review of the English-language literature was performed to identify outcomes instruments specific for targeted facial plastic surgery interventions and conditions. A search was performed using MEDLINE (1950 to September 2007), CINAHL (Cumulative Index to Nursing & Allied Health) (1982 to September 2007), and PsychINFO (1806 to September 2007). Outcomes instruments were categorized as patient-reported or clinical efficacy measures (observer-reported or objective measures). Instruments were then categorized to include relevant details on the intervention, degree of validation, and subsequent use.
  
  
  RESULTS
  Sixty-eight distinct instruments were identified (23 patient-reported, 35 observer-reported, and 10 objective measures), with some overlap among categories. Most patient-reported measures (76%) and half observer-reported instruments (51%) were developed in the past 10 years. The rigor of validation varied widely among measures, with formal validation being most common among the patient-reported outcome measures.
  
  
  CONCLUSIONS
  Validated outcomes measures are present for many common facial plastic surgery conditions and have become more prevalent during the past decade, especially for patient-reported outcomes. Challenges remain in harmonizing patient-reported, observer-based, and other objective measures to produce standardized clinically meaningful outcome measures.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jrhee@mcw.edu
authors.forename: John S
authors.initials: JS
authors.lastname: Rhee
authors.forename: Brian T
authors.initials: BT
authors.lastname: McMullin
mesh_terms: D005145:Face / Q000601:surgery*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome