title: Preferences and utilities for health states after treatment for oropharyngeal cancer: transoral robotic surgery versus definitive (chemo)radiotherapy.
abstract: BACKGROUND
  Treatment of oropharyngeal cancer with transoral robotic surgery (TORS) or definitive (chemo)radiotherapy impacts quality of life. Utility scores are needed for quality of life and economic comparisons.
  
  
  METHODS
  Fifty healthy subjects and 9 experts reviewed scenarios describing treatment (TORS alone or with adjuvant radiotherapy or chemoradiotherapy [CRT], definitive radiotherapy, and CRT), complications, remission, and recurrences. Utilities were assessed using visual analog scale (VAS) and standard gamble (SG) techniques. Treatments were compared using paired comparisons and demographic variability was assessed.
  
  
  RESULTS
  TORS had higher SG utilities than radiotherapy (p = .001) and CRT (p < .001) and was preferred in paired comparisons (p < .001 for both) for healthy subjects. Utilities did not vary by demographic group and correlated between experts and subjects (VAS r = 0.95; p < .001; SG r = 0.97; p < .001).
  
  
  CONCLUSIONS
  TORS has higher utility scores than CRT. Utilities can be used for cost-utility analyses.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, New York.
authors.forename: John R
authors.initials: JR
authors.lastname: de Almeida
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Villanueva
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Moskowitz
authors.forename: Brett A
authors.initials: BA
authors.lastname: Miles
authors.forename: Marita S
authors.initials: MS
authors.lastname: Teng
authors.forename: Andrew
authors.initials: A
authors.lastname: Sikora
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
authors.forename: Marshall
authors.initials: M
authors.lastname: Posner
authors.forename: Eric M
authors.initials: EM
authors.lastname: Genden
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D057240:Patient Preference; D011183:Postoperative Complications; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D065287:Robotic Surgical Procedures; D064232:Visual Analog Scale; D055815:Young Adult
keywords: chemoradiotherapy; health states; oropharyngeal cancer; preferences; transoral robotic surgery; utilities