PhD defence F.V.W.J. (Floris) van Zijl

Dissertation in short:

Over the past years, increasing pressure is exerted on healthcare providers to communicate outcome data. Outcomes reflect the change in health status following treatment, and are essential to evaluate the effectiveness of healthcare. Patients rely on outcome information to make educated decisions about their health, providers to choose the most suitable treatment and monitor their performance, and governments and insurance carriers to improve quality and cost-effectiveness of healthcare. In functional and aesthetic nasal surgery, or rhinoplasty, outcomes of rhinoplasty are not routinely measured. The resulting lack of outcome data hinders the establishment of high-level evidence on the effectiveness of rhinoplasty, and compromises transparency about rhinoplasty results towards patients and third parties. The aim of this thesis, therefore, is to increase and enhance routine outcome measurements in rhinoplasty. We attempted to answer what outcome instruments to use by presenting an evidence-based recommendation on the best patient-reported outcome measure (PROM) to evaluate the effects of rhinoplasty. Second, a prospective rhinoplasty outcome routine is presented, demonstrating how to systematically measure outcomes. Third, we outlined the advantages of routine outcome measurements in both functional-aesthetic and secondary cleft-lip rhinoplasty patients, that emphasize why to measure outcomes in rhinoplasty. This is complemented with a methodology that allows surgeons to use their own data to assess personal surgical performance and identify needs for improvement. The set of studies is concluded by an experimental study, investigating a method to objectively quantify aesthetic outcomes in rhinoplasty.