{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:09:21Z","timestamp":1785470961291,"version":"3.56.0"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T00:00:00Z","timestamp":1564963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The impact of disease states can be measured using health state utilities, which are values that reflect economic preferences for health outcomes. Utilities for dysphonia have not been studied using direct methods. The objective of this project was to establish the baseline health utilities of mild and severe dysphonia from a societal perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Direct utility elicitation survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four health states (monocular blindness, binocular blindness, mild dysphonia, and severe dysphonia) were evaluated by a convenience sample of adults recruited from the general public with three computer\u2010aided estimation techniques (visual analog scale [VAS], standard gamble [SG], and time trade\u2010off [TTO]). Standardized descriptions and voice recordings from multiple dysphonic patients were employed. Perfect health was defined as a utility of 1, with death 0. Analysis of variance with post hoc pairwise comparison was used to calculate significant differences between health states.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred participants were surveyed, and 225 (75.0%) responses met quality thresholds. Severe dysphonia (VAS = 48.3, SG = 0.810, TTO = 0.798) was valued significantly worse than monocular blindness (VAS = 56.2, SG = 0.834, TTO = 0.839) on the VAS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and equivalent on SG and TTO; it was preferred over binocular blindness (VAS = 25.7, SG = 0.631, TTO = 0.622;<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) with all methods. Mild dysphonia evaluated favorably with all methods to the other health states (VAS = 78.5, SG = 0.902, TTO = 0.908;<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Voice disorders may have a measurable impact on utility, with severe dysphonia valued equivalently to monocular blindness. Mild dysphonia has a utility decrement from perfect health. These estimates are critical for quality\u2010of\u2010life assessment and could be used to assess cost\u2010effectiveness of treatments for voice disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 130:1256\u20131262, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28216","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T14:15:00Z","timestamp":1565014500000},"page":"1256-1262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The health utility of mild and severe dysphonia"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7034-9238","authenticated-orcid":false,"given":"Elliana K.","family":"DeVore","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"},{"name":"Center for Global Surgery Evaluation Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Wittenberg","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science Harvard T. 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