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A comparison of attitudes to laryngeal cancer treatment outcomes: A time trade-off study

Lookup NU author(s): David Hamilton, Dr Peter McMeekin, Emeritus Professor Richard Thomson, Professor Vinidh Paleri, Emerita Professor Janet WilsonORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell, 2018.

For re-use rights please refer to the publisher's terms and conditions.


© 2017 John Wiley & Sons Ltd. Design: Time trade-off choice experiment. Setting: Two large head and neck cancer centres. Participants: Patients who have received treatment for head and neck cancer and members of the head and neck cancer multidisciplinary team. Main outcome measures: Participants were asked to rank the outcome scenarios, assign utility values using time trade-off and rate the importance of survival on treatment choice. Results: A total of 49 patients with head and neck cancer and 73 staff members were recruited. Chemoradiotherapy (CRT) optimal outcome was the most preferred health state (34 of 49, 69% patients, and 50 of 73, 68% staff), and CRT with complications was least preferred (27 of 49, 55% patients, and 51 of 73, 70% staff). Using time trade-off, mean utility values were calculated for CRT optimal outcome (0.73 for patients, 0.77 for staff), total laryngectomy (TL) optimal outcome (0.67 for patients, 0.69 for staff), TL outcome with complications (0.46 for patients, 0.51 for staff) and CRT with complications (0.36 for patients, 0.49 for staff). The average survival advantage required for a participant to change their preferred choice was 2.6 years. Conclusions: We have demonstrated that a significant proportion of patients with head and neck cancer and staff members would not choose CRT to manage locally advanced laryngeal cancer. Staff members rated the health states associated with laryngeal cancer treatment higher than patients who have experienced them, and this is particularly evident when considering the poorer outcomes. The head and neck cancer community should develop methods of practice and decision-making which incorporate elicitation and reporting of patient values as a central principle.

Publication metadata

Author(s): Hamilton DW, Pedersen A, Blanchford H, Bins J, McMeekin P, Thomson R, Paleri V, Wilson JA

Publication type: Article

Publication status: Published

Journal: Clinical Otolaryngology

Year: 2018

Volume: 43

Issue: 1

Pages: 117-123

Print publication date: 01/02/2018

Online publication date: 19/05/2017

Acceptance date: 14/05/2017

Date deposited: 05/02/2021

ISSN (print): 1749-4478

ISSN (electronic): 1749-4486

Publisher: Wiley-Blackwell


DOI: 10.1111/coa.12906


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