{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:25:35Z","timestamp":1790504735164,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,6,29]],"date-time":"2015-06-29T00:00:00Z","timestamp":1435536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>(1) To define the minimal clinically important difference (MCID) of the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument, and (2) to test for the change in quality of life (QOL) after VPI surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>VPI clinic at a tertiary pediatric medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Children with VPI and their parents completed the VELO instrument (higher score is better QOL) at enrollment and then underwent VPI surgery (Furlow palatoplasty or sphincter pharyngoplasty, n = 32), other treatments (obturator or oronasal fistula repair, n = 7), or no treatment (n = 18). They completed the VELO instrument again and an instrument of global rating of change in QOL at 1 year. The MCID was anchored to the global change instrument scores corresponding to \u201ca little\u201d or \u201csomewhat\u201d better. Within\u2010group (paired <jats:italic>t<\/jats:italic> test) and between\u2010group (Student <jats:italic>t<\/jats:italic> test) changes in VELO scores were tested for the VPI surgery and no treatment groups. The association between treatment group and change in VELO scores was tested with multivariate linear regression, adjusting for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Follow\u2010up was obtained for 37 of 57 (65%) patients. The mean (\u00b1standard deviation) change in VELO scores corresponding to the MCID anchor was 15 \u00b1 13. The VELO score improved significantly more in the VPI surgery group (change, 22 \u00b1 15; <jats:italic>P<\/jats:italic> &lt;. 001) than in the no treatment group (change, 9 \u00b1 12; <jats:italic>P<\/jats:italic> =. 04), after adjusting for confounders (<jats:italic>P<\/jats:italic> =. 007 between groups).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VPI surgery using the Furlow palatoplasty or sphincter pharyngoplasty improves VPI\u2010specific QOL, and the improvement is clinically important.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815591159","type":"journal-article","created":{"date-parts":[[2015,6,29]],"date-time":"2015-06-29T23:05:30Z","timestamp":1435619130000},"page":"857-864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Change in Quality of Life with Velopharyngeal Insufficiency Surgery"],"prefix":"10.1002","volume":"153","author":[{"given":"Jonathan R.","family":"Skirko","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward M.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Seattle Washington USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head &amp; Neck Surgery Seattle Children\u2019s Hospital Seattle Washington USA"},{"name":"Childhood Communication Center Seattle Children\u2019s Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Kinter","sequence":"additional","affiliation":[{"name":"Speech and Language Services Seattle Children\u2019s Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Eblen","sequence":"additional","affiliation":[{"name":"Speech and Language Services Seattle Children\u2019s Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Martina","sequence":"additional","affiliation":[{"name":"Speech and Language Services Seattle Children\u2019s Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen C.Y.","family":"Sie","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Seattle Washington USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head &amp; Neck Surgery Seattle Children\u2019s Hospital Seattle Washington USA"},{"name":"Childhood Communication Center Seattle Children\u2019s Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamaoto.122"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813486081"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.3.224"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(89)90005-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.03.012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2004.06.002"},{"key":"e_1_2_8_8_1","unstructured":"HowickJ ChalmersI GlasziouP et al.Oxford Centre for Evidence\u2010based Medicine: levels of evidence.March 2009. Available at:http:\/\/www.cebm.net\/index.aspx?o=1025. Accessed February 18 2013."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198678060-00002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979282"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.2.9712036"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90036-1"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4065\/77.4.371"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198903001-00015"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116813"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815591159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599815591159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815591159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:28:27Z","timestamp":1760952507000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599815591159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,29]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1177\/0194599815591159"],"URL":"https:\/\/doi.org\/10.1177\/0194599815591159","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,29]]},"assertion":[{"value":"2014-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}