Author(s)
Lazaro Peraza, MD
Aja Leatherwood
Forrest Fearington, BS
Gabriel Hernandez-Herrera, BS
Alexis Grover, BS
Jacob Dey, MD
Andrea Tooley, MD
Janalee Stokken, MD
Affiliation(s)
Mayo Clinic;
Abstract:
Background: Thyroid eye disease (TED) is an autoimmune condition marked by proptosis, significantly impacting patients’ appearance and social experiences. While the physical effects of TED are well understood, its broader social and psychological burdens remain understudied, particularly regarding the social perceptions of those affected.
Aim: This study evaluates how differing severities of TED proptosis affect the perceived extent of facial deformity, quality of life (QoL), and the estimated value of corrective intervention.
Methods: 97 casual observers evaluated 8 images of female individuals with varying severities of TED alongside 4 controls. Respondents rated perceived deformity severity, QoL, perceived affect, willingness to trade years of life, and willingness to pay (WTP) for corrective intervention. Responses were analyzed with respect to demographic factors, including age, gender, and income.
Results: Observers’ WTP for corrective intervention was positively associated with proptosis severity (p< 0.001) and income, with high-income respondents (>$100,000) averaging $16,313, compared to $3,371 for those earning <$50,000. Participants were willing to trade more years of life for higher proptosis severities, ranging from 2.6 years (Hertel = 23) to 9.2 years (Hertel = 26.5). Observers associated worse proptosis with worsened QoL (p < 0.001), with mean ratings dropping from 79.3 (Hertel = 23) to 42.6 (Hertel = 26.5).
Conclusion: From the general public’s perspective, higher perceived proptosis severity in TED is associated with a substantial perceived social and economic burden, and corrective intervention has an estimated social value of thousands of dollars and many life-years.