Relating speech and swallow function to dropout in a longitudinal study of head and neck cancer

Laura A. Colangelo*, Jeri A. Logemann, Alfred W. Rademaker, Barbara Roa Pauloski, Christina H. Smith, M. S. McConnel, David W. Stein, Quinter C. Beery, Eugene N. Myers, Mary Anne Heiser, Salvatore Cardinale, Donald P. Shedd

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The relation between functional outcome and dropout from a 12-month follow-up period was examined in a longitudinal study whose objective was to define and quantify the functional effects of oral surgical resection and reconstruction on speech and swallowing in patients with head and neck cancer. In a group of 150 patients recruited to a surgical study in the Cancer Control Science Program in Head and Neck Cancer Rehabilitation, dropout from all causes and dropout from specific causes (medical, patient, and administrative specific) were assessed in relation to longitudinal speech and swallow function. In univariate analysis, better speech articulation was associated with decreased risk of dropout from all causes and from medical- specific causes. Better swallow performance was associated with decreased risk of medical-specific dropout. Multivariate analysis revealed the following: (1) only articulation function was associated with dropout from all causes; (2) the association of speech articulation function with medical dropout was diminished after adjusting for advanced age and surgical resection variables; (3) the association of speech articulation function became significant for patient-specific dropout after adjusting for advanced age and surgical resection variables and indicated that better function decreased the risk of this type of dropout; and (4) swallowing function was not related to dropout. Patients treated for oral or oropharyngeal cancer who have poorer speech outcomes are more likely to drop out from a longitudinal study. Basing study results on only patients who complete a longitudinal study will understate the level of dysfunction experienced.

Original languageEnglish (US)
Pages (from-to)713-719
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume121
Issue number6
DOIs
StatePublished - 1999

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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