Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Divisions of Rhinology and Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Facial Plast Surg Aesthet Med. 2020 Jul/Aug;22(4):268-273. doi: 10.1089/fpsam.2020.0011. Epub 2020 Apr 13.
The importance of this study is to understand the impact of rhinoplasty as perceived by society and to conceptualize the health utility metric of cosmetic rhinoplasty in relation to other health interventions. This novel study seeks to measure and quantify the health state utility and valuation of cosmetic rhinoplasty. This is a cross-sectional survey administered through public online forums to 161 casual observers in America. Participants were shown pre- and postoperative photographs of six patients who underwent cosmetic rhinoplasty and two patients who did not undergo surgery. Observers were asked to imagine that the external nose in each image was on their own face and rated (1) their health state utility and (2) how much they were willing to pay (WTP) to have the ideal nose. Established metrics of standard gamble and visual analog scale were explored in detail. Using these valuation and health utility data, we calculated WTP per quality-adjusted-life-year (WTP/QALY). The WTP/QALY for cosmetic rhinoplasty is $12,264 per QALY, which is significantly below cost-effective thresholds. Participants were willing to accept 10% risk of death to undergo cosmetic rhinoplasty. Calculating WTP/QALY as a metric, we assess and quantify the social importance of rhinoplasty. This is the first study to demonstrate that elective cosmetic rhinoplasty can be a high-value intervention as perceived by society. Furthermore, the high percentage of risk of death that participants are willing to accept for cosmetic rhinoplasty suggests there is a profound psychosocial impact of external nasal deformity. These findings have implications for patients, surgeons, and health policy makers.
这项研究的重要性在于了解社会对鼻整形术的影响，并将美容鼻整形术的健康效用指标与其他健康干预措施联系起来。这项新颖的研究旨在测量和量化美容鼻整形术的健康状态效用和价值。这是一项通过公共在线论坛向 161 名美国普通观察者进行的横断面调查。参与者被展示了六名接受美容鼻整形术和两名未接受手术的患者的术前和术后照片。观察者被要求想象每张图像中的外鼻在自己的脸上，并对（1）自己的健康状态效用和（2）他们愿意支付（WTP）的金额进行评分，以拥有理想的鼻子。详细探讨了标准博弈和视觉模拟量表的既定衡量标准。使用这些估值和健康效用数据，我们计算了每质量调整生命年的支付意愿（WTP/QALY）。美容鼻整形术的 WTP/QALY 为 12264 美元/QALY，明显低于成本效益阈值。参与者愿意接受 10%的死亡风险来接受美容鼻整形术。作为一种衡量标准，我们计算 WTP/QALY，评估和量化鼻整形术的社会重要性。这是第一项表明社会认为选择性美容鼻整形术可以是一种高价值干预的研究。此外，参与者愿意为美容鼻整形术承担的高死亡风险百分比表明，外鼻畸形存在深远的心理社会影响。这些发现对患者、外科医生和卫生政策制定者都有影响。
