title: Patients' priorities among treatment effects in head and neck cancer: evaluation of a new assessment tool.
abstract: BACKGROUND
  Patients with head and neck cancer may face decisions between surgery or radiation (with or without chemotherapy) which involve significant trade-offs in functional outcomes. This preliminary investigation is designed to examine patients' priorities among the effects of treatments for head and neck cancer.
  
  
  METHODS
  A new instrument designed to allow patients to rank personal priorities among 12 treatment effects was developed and tested. A cross section of patients (19) from pretreatment and posttreatment time periods and 23 controls participated.
  
  
  RESULTS
  Preliminary findings indicate high individual variability, with some differences between groups according to treatment time. Differences between patients and controls are evident. We report test-retest reliability and the limitations of this new tool.
  
  
  CONCLUSIONS
  The data suggest that measures of health state values should be conducted with patients rather than healthy volunteers. Patients' priorities may be influenced by treatment and some values may be more susceptible to change with experience of treatment effects. This new tool may provide insight into how patients' prioritize the anticipated and experienced effects of treatment for head and neck cancers.
authors.affiliation: MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Sharp
authors.forename: M
authors.initials: M
authors.lastname: List
authors.forename: E
authors.initials: E
authors.lastname: MacCracken
authors.forename: K
authors.initials: K
authors.lastname: Stenson
authors.forename: C
authors.initials: C
authors.lastname: Stocking
authors.forename: M
authors.initials: M
authors.lastname: Siegler
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003657:Decision Making; D003679:Deglutition / Q000502:physiology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D013060:Speech / Q000502:physiology; D015996:Survival Rate; D014831:Voice / Q000502:physiology