Editor—Sanders et al’s bibliographic study on the frequency and detail of reporting on quality of life data in randomised controlled trials listed in the Cochrane Controlled Trials Register is disturbing.1 Despite increasing emphasis on patient centred outcomes in all aspects of clinical practice and research, less than 5% of trials reported on quality of life and even fewer comprehensively reported the quality of data using well validated, familiar instruments.
Deyo and Patrick discussed methodological, attitudinal, and conceptual barriers to the use of quality of life assessments in research in 1989.2 They noted the paucity of information regarding the responsiveness, reliability, validity, and psychometric characteristics of most instruments. In the 1980s many authors noted the problem of a confusing array of instruments, including scales with the same purpose.2,3 Feinstein et al noted 43 scales measuring activities of daily living.3
Deyo and Patrick suggested increased reporting of studies that compared different quality of life instruments in the same population and comparing the use of generic instruments in different diagnostic groups. They also advocated testing any newly developed instruments against well established scales and the development of a “quality of life research laboratory” to aid researchers with the analysis and standardisation of data on quality of life.2
In the light of Sanders et al’s study, all trialists need to think again about the suggestions above. The CONSORT guidelines could be expanded to include recommendations on which tested, well validated quality of life instruments should be selected for use in different situations. This would aid researchers’ choice and improve standardisation and generalisability.
References
- 1.Sanders C, Egger M, Donovan J, Tallon D, Frankel S. Reporting on quality of life in randomised controlled trials: bibliographic study. BMJ. 1998;317:1191–1194. doi: 10.1136/bmj.317.7167.1191. . (31 October.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Deyo R, Patrick D. Barriers to the use of health status measures in clinical investigation, patient care and policy research. Med Care. 1989;27:S254–S268. doi: 10.1097/00005650-198903001-00020. [DOI] [PubMed] [Google Scholar]
- 3.Feinstein AR, Josephy BR, Wells CK. Scientific and clinical problems in indexes of functional disability. Ann Intern Med. 1986;105:413. doi: 10.7326/0003-4819-105-3-413. [DOI] [PubMed] [Google Scholar]