Classics from The Laryngoscope: celebrating 120 years of impact.

In this issue, we have reprints from two classic articles, which were published in this journal, both on the field of outcomes research. It gives me great pleasure to write this—outcomes research being my own area of academic interest—and also great pride that these two seminal papers by pioneers in the field were published in The Laryngoscope. In 1995, Gliklich and Metson reported the design and validation of one of the very first disease-specific quality-of-life (QOL) instruments in otolaryngology: the Chronic Sinusitis Survey. The instrument was validated for use in chronic rhinosinusitis and was subsequently used by them and other researchers to measure the impact of disease, as well as the improvement in QOL after treatment. This study prompted many others in the field to start developing disease-specific QOL instruments for a number of different diseases. The other point illuminated by this article was the significant QOL impact of otolaryngologic disease. Many head and neck diseases, although not fatal, still cause significant QOL impairment, and their successful treatment is a major QOL improvement for the patient. In 2000, Piccirillo’s Triological Society Thesis was on comorbidity in head and neck cancer. Comorbidity, the impact of a different disease on the primary outcome being measured, was gaining some traction in health services research. However, it had never been explored so extensively in otolaryngology until this significant work. The author had been incorporating comorbidity data into a large institutional cancer database for several years. Using those data he evaluated the presence and severity of comorbidity in cancer patients and the impact of comorbidity on survival, and then compared these factors between cancers from different sites (colorectal, lung, breast, gynecological, and prostate) with head and neck cancer. The study found that 21% of head and neck cancer patients had moderate to severe comorbidity, and the only sites higher were lung and colorectal. Moderate or severe comorbidity had a significant impact on survival, independent of tumor-node-metastasis stage, and the impact of comorbidity on survival was higher for head and neck cancer than for colorectal, gynecologic, and lung cancer. The implications from this work have been significant, and have affected policy and treatment recommendations in many settings. I could only select two articles to highlight for this issue, and I had the nice problem of having to select from many other worthy articles on outcomes research that have been published in The Laryngoscope. I hope the reader enjoys this look into the recent past as much as I have.