Study Predicts Ideal Cleft Lip Patients for Procedures in Ambulatory Surgical Centers

Uplift modeling predicts that 40 percent of cleft lip repairs could be performed in an ASC, offering patients a lower-cost, safe option

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The Cleft Palate-Craniofacial Journal (CPCJ)

Mar 14, 2019, 12:20 ET

CHAPEL HILL, N.C., March 14, 2019 /PRNewswire/ -- Approximately 40 percent of patients would benefit from having their cleft lip repair surgery in an ambulatory surgical center (ASC), instead of a traditional hospital setting, according to research published in the February 2019 issue of The Cleft Palate-Craniofacial Journal (CPCJ).

"The shift toward using ASCs for cleft lip repair surgery is being driven by a growing interest to reduce medical costs," said Victor Chang, lead researcher. "However, we must use caution to select the most appropriate patients for the ASC setting. Patients should be screened for certain pre-existing medical conditions to help ensure the best possible outcome."

The study, Predicting the Ideal Patient for Ambulatory Cleft Lip Repair, used uplift modeling to demonstrate which patients can be ideally treated in an ASC. Research focused on 2,881 patients under the age of 18 who underwent a cleft repair in California between 2007-2011, the largest study of this type ever conducted. Of the sampling, 2,383 (83 percent) were performed in an inpatient facility and 498 (17 percent) were conducted in an ASC.

ASC patients were more likely to be black or Hispanic, have a lower number of procedures, and undergo a simple cleft lip repair rather than a combined cleft lip and palate repair; and less likely to have a diagnosis of failure to thrive and be syndromic. Researchers concluded that surgeons selected patients for ASC cleft repairs based on demographics, absence of certain diagnoses, and the total number and type of procedures.

"By using uplift modeling predictions, we can offer ACS as a safe, cost-saving option to younger, nonsyndromic patients with no respiratory or neurologic diagnosis," Chang said.

"In recent years, due to progressive tightening of funds and resources, surgical decision making has become a subject of intense study. Many are now advocating for protocol-driven pathways to improving care while reducing costs, like the uplift model," said Dr. Jack C. Yu, editor of CPCJ. "As the trend toward artificial intelligence continues, it is critically important that we keep patient safety and surgical quality as the primary driver."

To view a full version of this release and the study, visit acpa-cpf.org.

SOURCE The Cleft Palate-Craniofacial Journal (CPCJ)