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Translation and pilot study of the Cleft Hearing Appearance and Speech Questionnaire (CHASQ)

Stiernman, Mia; Maulina, Ieva; Zepa, Inta; Jagomägi, Triin; Tanaskovic, Nenad; Knežević, Predrag; Velikova, Radost; Anastassov, Youri; Radojićić, Julija; Pesic, Zoran; Trifunović, Branislav; Drevensek, Martina; Spataru, Radu; Boljevic, Tanja; Dimovska, Radmila; Naumovski, Slave; Rumsey, Nichola; Zucchelli, Fabio; Sharratt, Nicholas; Argyrides, Mario; Klintö, Kristina; Becker, Magnus; Persson, Martin


Mia Stiernman

Ieva Maulina

Inta Zepa

Triin Jagomägi

Nenad Tanaskovic

Predrag Knežević

Radost Velikova

Youri Anastassov

Julija Radojićić

Zoran Pesic

Branislav Trifunović

Martina Drevensek

Radu Spataru

Tanja Boljevic

Radmila Dimovska

Slave Naumovski

Nichola Rumsey

Mario Argyrides

Kristina Klintö

Magnus Becker

Martin Persson



There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument.


The PRO measure—CHASQ—was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis.


Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians’ role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument.


Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families.


Stiernman, M., Maulina, I., Zepa, I., Jagomägi, T., Tanaskovic, N., Knežević, P., …Persson, M. (2019). Translation and pilot study of the Cleft Hearing Appearance and Speech Questionnaire (CHASQ). European Journal of Plastic Surgery, 42(6), 583-592.

Journal Article Type Article
Acceptance Date May 27, 2019
Online Publication Date Jun 7, 2019
Publication Date Dec 1, 2019
Deposit Date Jun 12, 2019
Journal European Journal of Plastic Surgery
Print ISSN 0930-343X
Electronic ISSN 1435-0130
Publisher Springer (part of Springer Nature)
Peer Reviewed Peer Reviewed
Volume 42
Issue 6
Pages 583-592
Keywords cleft, appearance, CHASQ, visible difference
Public URL
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