title: Clinical relevance of quality-of-life data in laryngectomized patients.
abstract: OBJECTIVE
  Statistically significant differences in health-related quality of life (HRQL) are not always clinically relevant. It is also plausible that patients perceive other changes to be relevant than health professionals do. The objective of this study was to find thresholds for HRQL that laryngectomees consider to be clinically relevant 1 year after surgery, (i.e., the level of HRQL that patients rate as satisfactory). A second aim was to investigate how many laryngectomized patients reached those targets.
  
  
  METHODS
  Multicenter cross-sectional study.
  
  
  METHODS
  A total of 28 patients 1 year following laryngectomy and 24 healthcare professionals (HCPs) defined target values for the QLQ-C30 and QLQ-H&N35. In another sample of 157 laryngectomized patients 1 year following laryngectomy, we determined what percentage of patients reached these thresholds.
  
  
  RESULTS
  Patients are the most accepting of sensory impairments (56.5), coughing (53.6), and dyspnea (44.0), whereas constipation (9.1) and nausea/vomiting (10.7) were rated as being the most troublesome symptoms. HCPs assessed more of the studied complaints as being tolerable than patients did, especially in psychosocial domains. Between 34.5% (senses) and 86.5% (constipation) of the reference group hit the predefined targets at different scales.
  
  
  CONCLUSIONS
  Symptoms caused by disease are easier for patients to live with than more general nonspecific symptoms. Taking into account that some adverse effects of disease or therapy are partially irreversible, target values additional to changes of HRQL can be helpful when interpreting data.
authors.affiliation: Department of Social Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Fahsl
authors.forename: Judith
authors.initials: J
authors.lastname: Keszte
authors.forename: Andreas
authors.initials: A
authors.lastname: Boehm
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Vogel
authors.forename: Wolfram
authors.initials: W
authors.lastname: Völkel
authors.forename: Eberhard F
authors.initials: EF
authors.lastname: Meister
authors.forename: Jens
authors.initials: J
authors.lastname: Oeken
authors.forename: Annett
authors.initials: A
authors.lastname: Sandner
authors.forename: Sven
authors.initials: S
authors.lastname: Koscielny
authors.forename: Angela
authors.initials: A
authors.lastname: Kluge
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Heim
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life