Methods
Anonymous surveys (in English and Spanish; see Supplemental Material)
were distributed to patients at the waiting room of an otolaryngology
clinic at a tertiary care center from February 2019 to July 2019.
Informed consent was obtained. Adults > 18 years old were
instructed to rate how much they value various outcomes when undergoing
hypothetical ear surgery on a scale of 0 (not important) to 10 (very
important). Outcomes included visibility of the scar, cost of the
surgery to the hospital (not to the patient), pain control, time spent
under anesthesia, hearing, having an incision hidden in the ear canal
(no outside scar), not having postoperative numbness, size of the
incision, and friendliness of staff. Color of the bandage given after
surgery was included as a negative control to gauge the overall validity
of the survey responses; presumably, this outcome should not be
maximally valued for a patient undergoing ear surgery. Multivariable
linear regression was used to analyze demographic predictors of valued
outcomes; covariates included age, gender, and Spanish-speaking status.
Value was categorized into groups as follows: high value (8 to 10),
moderate (5 to 8), low (2 to 5), and minimal (0 to 2). Institutional
Review Board Approval was obtained for this study. The STROBE reporting
guidelines for cross-sectional studies were followed in manuscript
preparation.