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Quality compared to quantity of life in laryngeal cancer: A time trade‐off study
Author(s) -
Hamilton David W.,
Bins Janneke E.,
McMeekin Peter,
Pedersen Ami,
Steen Nicholas,
De Soyza Anthony,
Thomson Richard,
Paleri Vinidh,
Wilson Janet A.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24061
Subject(s) - laryngectomy , chemoradiotherapy , medicine , larynx , quality of life (healthcare) , time trade off , head and neck cancer , cancer , outcome (game theory) , surgery , physical therapy , nursing , mathematical economics , mathematics
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. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E631–E637, 2016