ORIGINAL ARTICLE Measurement of Health-Related and Oral Health–Related Quality of Life Among Individuals With Nonsyndromic Orofacial Clefts: A Systematic Review and Meta-Analysis Ana Paula Corr ˆ ea de Queiroz Herkrath, B.D.S., M.Sc., Fernando Jos ´ e Herkrath, B.D.S., M.Sc., Maria Augusta Bessa Rebelo, B.D.S., M.Sc., Ph.D., Mario Vianna Vettore, B.D.S., M.Sc., Ph.D. Objective: To compare health-related quality of life and oral health–related quality of life between nonsyndromic individuals with and without cleft lip and/or cleft palate and to identify the most affected quality of life dimensions in individuals with cleft lip and/or palate. Design: Systematic review and meta-analysis were conducted. Of the 314 identified citations, 23 articles were submitted to quality assessment. Data from nine studies on health-related quality of life and six on oral health–related quality of life were extracted for meta-analysis. Main Outcome Measures: Pooled mean differences of health-related quality of life between adults with and without cleft lip and/or palate, pooled means of health-related quality of life dimensions of children and adults with cleft lip and/or palate and oral health–related quality of life dimensions of children and adolescents with cleft lip and/or palate with a 95% confidence interval were calculated. Results: Quality assessment revealed methodological differences between studies. Lack of subgroup stratification and absence of control for confounders were the main limitations. Heterogeneity was detected on the comparison of oral health–related quality of life and health- related quality of life between children with and without cleft lip and/or palate, and oral health– related quality of life between adolescents with and without cleft lip and/or palate. A random- effect model showed a significant difference on health-related quality of life between adults with and without cleft lip and/or palate (mean difference ¼ 0.10; 95% confidence interval, 0.16 to 0.05). Psychological health (mean, 78.9; 95% confidence interval, 70.1 to 87.7) and vitality (mean, 68.1; 95% confidence interval, 48.0 to 88.1) were the most affected health-related quality of life dimensions in children and adults with cleft lip and/or palate, respectively. Means of health- related quality of life dimensions in children and adults with cleft lip and/or palate and oral health–related quality of life in children and adolescents with cleft lip and/or palate varied yet did not differ in indirect comparisons. Conclusion: The presence of cleft lip and/or palate negatively affected the health-related quality of life of adults, mainly on psychosocial dimensions. KEY WORDS: cleft lip, cleft palate, meta-analysis, quality of life Quality of life (QoL) measures have been used as indicators to evaluate the effectiveness, efficiency, and impact of distinct treatments for different diseases or health disorders (Seidl and Zannon, 2004). Successful medical treatments should not consider only the cure, remission, or disease control but also the maintenance or improvement of patients’ QoL (Homer et al., 1998; Perrin, 2002). From a public health perspective, QoL measures have become commonly used in the assessment of public health policies and health care interventions at community levels (Bowling, 2005). According to the World Health Organization, QoL is the ‘‘individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’’ (World Health Organization Quality of Life Group, 1995, p. 1405). Health-related quality of life (HRQoL) is one dimension of QoL (Bowling, 2005) and can be described as the impact of health status or disease and treatment on different aspects of life (Wehby et al., 2006; Sagheri et al., 2009). Oral health–related quality of life (OHRQoL) is a more specific QoL concept and refers to the Dr. Queiroz Herkrath is Ph.D. student in Epidemiology and Public Health, National School of Public Health, Oswaldo Cruz Foundation. Mr. Herkrath is Lecturer–Orthodontics; and Dr. Rebelo is Associate Professor, School of Dentistry, Federal University of Amazonas, Amazonas, Brazil. Dr. Vettore is Lecturer–Dental Public Health, Dental Public Health Unit, School of Clinical Dentistry, University of Sheffield, City, Country. Submitted May 2013; Revised December 2013, January 2014; Accepted January 2014. Address correspondence to: Dr. Ana Paula Corrˆea de Queiroz Herkrath, School of Dentistry, Federal University of Amazonas, Av. Min. Valdemar Pedrosa, 1539, Centro, Manaus, Amazonas, Brazil, CEP 69025-050. E-mail anapaulaqueiroz@gmail.com. DOI: 10.1597/13-104 0 The Cleft Palate–Craniofacial Journal 00(00) pp. 000–000 Month 2014 Ó Copyright 2014 American Cleft Palate–Craniofacial Association