Exploring the Laryngectomy Pathway Experience-a Mixed-Method, Patient Journey Mapping Study of Two US Health Centres.

Very small sample: 12 patients from one US health system, 9 interviewed. The authors acknowledge this and note that laryngectomy is low-incidence (~4,500/year in the US), making larger single-site studies impractical. Experiential ratings were collected by the treating SLP who had an ongoing clinical relationship with each participant, introducing a plausible under-reporting of negative experiences. Only patients with surgical voice restoration (voice prosthesis) were included; those using electrolarynx or other alaryngeal communication methods were excluded, so the findings may not generalise to them. Three participants died between consent and the interview phase, and more were lost from Site 2, reducing the final analytic sample to 9 for the qualitative component. The study is restricted to one privatised US health system; results may not apply to public health services or other countries with different funding and referral models. Comorbidity-related care (e.g., Participant 9's Crohn's disease) was not systematically captured, so the true healthcare burden for patients with multiple conditions is likely understated. Patient recall of appointments may have led to under-reporting of visits, particularly for services at external facilities.

The authors declare no conflicts of interest and no funding sources.

Do not read the median 77% positive rating as evidence that this care pathway is working well. The ratings were collected by the treating SLP who had an ongoing clinical relationship with each patient, which the authors themselves flag as a source of potential under-reporting of negative experiences. This is a descriptive study of 12 people in one health system; it maps what the pathway looks like and where patients struggle, but it does not compare pathways, test an intervention, or establish that the current model produces good outcomes.