ImportancePatient-reported outcome measures (PROMs) allow clinicians and researchers to assess health-related information from a patient’s perspective. These measures have been used more frequently over the last several decades, but an associated minimal clinically important difference (MCID) is needed to optimize their utility. This narrative review identified the top 100 most-cited otolaryngology-related PROM development and validation publications and assessed the presence and characteristics of the PROMs’ associated MCID.ObservationsIn this narrative review, a literature search in Scopus and Web of Science was conducted on June 29, 2022, using keywords related to PROM development and validation studies in otolaryngology and reference lists. Studies that met the definition of a PROM and assessed an otolaryngologic disorder or study population were included for full-text review. After full-text review of 188 articles, the top 100 most-cited PROM development and validation publications, resulting in 106 total PROMs, were chosen for review. A total of 39 (37%) of the identified PROMs had an associated MCID. Of those reporting an MCID, 14 (35.9%) used an anchor-based method, 12 (30.8%) used a distribution-based method, 10 (25.6%) used both, and 3 (7.7%) did not specify or used neither method. Rhinology had the greatest number of PROMs with an associated MCID (16 of 24, 66%), and pediatrics had the fewest (1 of 13, 7.7%). The median number of citations of PROMs with an MCID was higher than those without an MCID.Conclusions and RelevanceThe majority of the most-cited PROMs in otolaryngology lack an associated MCID. These data indicated that there are a multitude of PROMs that have been cited hundreds of times and used for decades without the ability to identify whether a particular change in score on the instrument is clinically meaningful. There is a need to determine and validate MCIDs for commonly used PROMs to aid clinical research and trial interpretation.

ObjectivesTo compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls.MethodsOropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole‐mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow‐up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session (“My sense of taste bothers me” on a 5‐point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within‐subject changes in CGI and psychophysical scores were computed. “Worsened taste” was a CGI increase by ≥1 point at follow‐up.ResultsOf 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow‐up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%–76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9–45%]). Tumor‐ipsilateral taste identification (TI) decreased more in patients (−11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0–19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes.ConclusionsPatient‐reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor‐ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long‐term symptom burden of TORS‐associated TDs will aid in the management of oropharyngeal cancer patients.Level of EvidenceLevel 3 (non‐randomized controlled cohort study) Laryngoscope, 2023