title: Impact of a laryngectomy on quality of life: perspective of the patient versus that of the health care provider.
abstract: This study retrospectively assesses the impact of laryngectomy on the quality of life of 46 patients as compared to the perception of the impact of laryngectomy of 13 health care providers (HCPs). Employing the "time trade-off" methodology, we assessed patient and HCP preferences and calculated estimated utilities. We found that 20% of patients would be willing to compromise anticipated life expectancy to preserve voice or preoperative quality of life. By comparison, 46% of the HCPs perceived that their patients would be willing to accept a reduced life span in order to preserve their larynx and quality of life. In conclusion, the percentage of HCPs who believed their patients would compromise survival was substantially higher than the percentage of actual patients who expressed this preference. This perception may influence physicians' attitudes toward recommending laryngeal preservation therapy for their patients. For most laryngectomy patients, treatments attempting laryngeal preservation, particularly if associated with compromised survival, may not be warranted.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio 78284-7777, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Otto
authors.forename: R A
authors.initials: RA
authors.lastname: Dobie
authors.forename: V
authors.initials: V
authors.lastname: Lawrence
authors.forename: C
authors.initials: C
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012959:Socioeconomic Factors