title: Interpretation of the Swedish Self Evaluation of Communication Experiences after Laryngeal cancer: Cutoff levels and minimum clinically important differences.
abstract: BACKGROUND
  The purpose of this study was to establish minimum clinically important difference (MCID) scores for the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer (S-SECEL) in order to facilitate clinical interpretation and identify cutoff values for voice rehabilitation.
  
  
  METHODS
  One hundred nineteen patients with laryngeal cancer completed the S-SECEL instrument and an anchor question regarding acceptability of speech in a social context pretreatment and 12-month postoncologic treatment. Receiver operating characteristic (ROC) curves analysis was used for calculation of cutoff values.
  
  
  RESULTS
  Voice rehabilitation cutoff values were identified for all domains (Total = 20; General = 4; Environmental = 16, and Attitudinal = 5), presenting acceptable sensitivity and specificity. Initial MCID estimates were obtained for all domains; improvement of -13 points (p < .0001) or a deterioration of +8 points (p = .035) for the Total domain.
  
  
  CONCLUSIONS
  MCID and cutoff scores for the S-SECEL have been identified and may be used in clinical practice to help identify patients with laryngeal cancer in need of voice rehabilitation.
authors.affiliation: Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Lisa
authors.initials: L
authors.lastname: Tuomi
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Mia
authors.initials: M
authors.lastname: Johansson
authors.affiliation: Department of Molecular and Clinical Medicine/Multidisciplinary Pain Center, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Paulin
authors.initials: P
authors.lastname: Andréll
authors.affiliation: Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Caterina
authors.initials: C
authors.lastname: Finizia
mesh_terms: D000368:Aged; D003147:Communication Disorders / Q000175:diagnosis* / Q000209:etiology; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012372:ROC Curve; D013060:Speech; D011795:Surveys and Questionnaires; D014831:Voice
keywords: Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer (S-SECEL); laryngeal neoplasms; patient outcome assessment; quality of life; voice