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"Lessons from American Board of Plastic Surgery Maintenance of Certification Tracer Data: A Sixteen Year Review of Clinical Practice Patterns and Evidence-Based Medicine in Cleft Palate Repair."

Kearney, A. M.; Gart, M. S.; Brandt, K. E.; Gosain, A. K.

Plast Reconstr Surg. 2020 Apr 30

Abstract

INTRODUCTION: As a component of the Maintenance of Certification (MOC) process from 2003 to 2019, the American Board of Plastic Surgery (ABPS) tracked 20 common plastic surgery operations. By evaluating the data collected over 16 years, we are able to examine the practice patterns of pediatric/craniofacial surgeons in the United States. METHODS: Cumulative tracer data for cleft palate repair was reviewed as of April 2014 and September 2019. Evidence-Based Medicine (EBM) articles were reviewed. Results were tabulated in three categories: Pearls, or topics that were covered in both the tracer data and EBM articles. Second, topics that were covered by EBM articles but not collected in the tracer data. Finally, topics that were covered in tracer data but not addressed in EBM articles. RESULTS: 2,850 cases had been entered as of September 2019. With respect to pearls, pushback, von Langenbeck and Furlow repairs all declined in use while intravelar veloplasty increased. For items not in the tracer, the quality of studies relating to analgesia is among the highest out of all areas of study regarding cleft palate repair. In terms of variables collected by the tracer but not studied, in 2019, 41% of patients received more than one day of antibiotics. CONCLUSIONS: This article provides a review of cleft palate tracer data and summarizes the research in the field. Review of the tracer data enables cleft surgeons to compare their outcomes to national norms and provides an opportunity for them to consider modifications that may enhance their practice.

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