David W Hamilton1, Janneke E Bins2, Peter McMeekin1, Ami Pedersen3, Nicholas Steen1, Anthony De Soyza4,5, Richard Thomson1, Vinidh Paleri3, Janet A Wilson3. 1. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom. 2. Jeroen Bosch Hospital, Hertogenbosch, The Netherlands. 3. Freeman Hospital, Newcastle upon Tyne, United Kingdom. 4. Institute of Cellular Medicine, Respiratory Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom. 5. Respiratory Medicine Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Abstract
BACKGROUND: The purpose of this study was to use time trade-off to assess the factors influencing patients' decisions in advanced laryngeal cancer. Time trade-off is a well-established method of assessing how individuals value a particular health state. METHODS: We developed vignettes depicting life after chemoradiotherapy or laryngectomy. One hundred fourteen participants ranked them, assigned utility values, and rated the importance of survival on treatment choice. RESULTS: Chemoradiotherapy was preferred by 62% and laryngectomy by 38%. Chemoradiotherapy optimal outcome had the highest mean utility value (0.64) followed by total laryngectomy optimal outcome (0.56). Total laryngectomy poor outcome (0.33) was equivalent to chemoradiotherapy poor outcome (0.32).The average survival advantage required for a participant to change their preferred choice was 2.1 years. CONCLUSION: The functional treatment outcome had a greater effect on health state utility values than treatment modality. In many individuals, larynx conservation may not be the primary consideration in treatment preference.
BACKGROUND: The purpose of this study was to use time trade-off to assess the factors influencing patients' decisions in advanced laryngeal cancer. Time trade-off is a well-established method of assessing how individuals value a particular health state. METHODS: We developed vignettes depicting life after chemoradiotherapy or laryngectomy. One hundred fourteen participants ranked them, assigned utility values, and rated the importance of survival on treatment choice. RESULTS: Chemoradiotherapy was preferred by 62% and laryngectomy by 38%. Chemoradiotherapy optimal outcome had the highest mean utility value (0.64) followed by total laryngectomy optimal outcome (0.56). Total laryngectomy poor outcome (0.33) was equivalent to chemoradiotherapy poor outcome (0.32).The average survival advantage required for a participant to change their preferred choice was 2.1 years. CONCLUSION: The functional treatment outcome had a greater effect on health state utility values than treatment modality. In many individuals, larynx conservation may not be the primary consideration in treatment preference.
Authors: Gregory T Wolf; Emily Bellile; Avraham Eisbruch; Susan Urba; Carol R Bradford; Lisa Peterson; Mark E Prince; Theodoros N Teknos; Douglas B Chepeha; Norman D Hogikyan; Scott A McLean; Jeffery Moyer; Jeremy M G Taylor; Francis P Worden Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-04-01 Impact factor: 6.223
Authors: David Winston Hamilton; Benjamin Heaven; Richard Thomson; Janet Wilson; Catherine Exley Journal: BMJ Open Date: 2022-08-24 Impact factor: 3.006