title: Identifying the effect of cleft type, deprivation and ethnicity on speech and dental outcomes in UK cleft patients: a multi-centred study.
abstract: BACKGROUND
  Outcome measures are increasingly important in the modern National Health Service. In the care of children born with cleft lip and/or palate there are many different outcomes to consider but only a few reliable, validated outcome measures exist. The dmft (decayed, missing and filled teeth) index and cleft speech characteristics (CSCs) are used regularly by cleft teams throughout the UK to assess outcomes in children with cleft lip and/or palate. We hypothesized that these two outcome measures might be significantly influenced by the demographics of the populations studied independent of the care provided.
  
  
  METHODS
  A retrospective review of all patients aged between five and six referred to three regional cleft centres during a twelve month period were included in the study. Speech and dental outcomes were compared with patient ethnicity, cleft type and level of deprivation as determined by the Carstairs score.
  
  
  RESULTS
  The data of 287 patients were used. Speech was significantly affected by cleft type (p < 0.03), whereas dentition was significantly affected by ethnicity (p = 0.002) and deprivation (p = 0.012).
  
  
  CONCLUSIONS
  This study demonstrates that the demographics of cleft populations can significantly affect the measures of outcome used to assess the quality of care provided by cleft teams. It has also demonstrated that these demographics are not evenly distributed across the country and that some cleft teams will have a more 'at risk' population than others.
  
  
  METHODS
  Risk, level II.
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, UK. Electronic address: rob_choa@hotmail.com.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Choa
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, UK.
authors.forename: Rona
authors.initials: R
authors.lastname: Slator
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Jeremy
authors.affiliation: Spires Cleft Centre, John Radcliffe Hospital Oxford and Salisbury District Hospital Salisbury, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Robinson
authors.affiliation: University Hospitals Bristol NHS Foundation Trust, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Franklin
authors.affiliation: South West Cleft Unit, Frenchay Hospital Bristol, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Roberts
authors.affiliation: South West Cleft Unit, Frenchay Hospital Bristol, UK.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Winter
authors.affiliation: South Wales Cleft Unit, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Extence
authors.affiliation: South Wales Cleft Unit, UK.
authors.forename: Mechelle
authors.initials: M
authors.lastname: Collard
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Clark
mesh_terms: D044466:Asian People; D002675:Child, Preschool; D002972:Cleft Palate / Q000145:classification* / Q000208:ethnology* / Q000601:surgery; D004245:DMF Index; D003731:Dental Caries / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013060:Speech; D006113:United Kingdom / Q000453:epidemiology; D044465:White People
keywords: Cleft lip and palate; Cleft type; Dentition; Deprivation; Ethnicity; Speech