Prophylactic Replacement of Voice Prosthesis | 183 7 PVPR in Monte-Carlo simulations Monte-Carlo simulations were run for the DL70 case varying the Coefficient of Variation (CV = SD/Mean) between zero and one (See Supplemental Information). The results showed that for a CV > 0.5 the benefits in terms of decreased number of leakage events per year (<50%) decreased considerably while the costs in terms of additional VPs increased significantly (>163%). For a median CV of 0.8 as found in our patient base, there are around 20% less leakages per year requiring some 170% more devices. In this simulation, increasing the DL70 to a higher value can marginally decrease the number of leakage events but with a mounting increase in the number of devices needed.
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