Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1992 Oct 31;305(6861):1074–1077. doi: 10.1136/bmj.305.6861.1074

Quality of life measures in health care. I: Applications and issues in assessment.

R Fitzpatrick 1, A Fletcher 1, S Gore 1, D Jones 1, D Spiegelhalter 1, D Cox 1
PMCID: PMC1883623  PMID: 1467690

Abstract

Many clinicians remain unsure of the relevance of measuring quality of life to their clinical practice. In health economics quality of life measures have become the standard means of assessing the results of health care interventions and, more controversially, the means of prioritising funding; but they have many other applications. This article--the first of three on measuring quality of life--reviews the instruments available and their application in screening programmes, audit, health care research, and clinical trials. Using the appropriate instrument is essential if outcome measures are to be valid and clinically meaningful.

Full text

PDF
1074

Images in this article

1076p1076-a
on p.1076

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaronson N. K. Quality of life assessment in clinical trials: methodologic issues. Control Clin Trials. 1989 Dec;10(4 Suppl):195S–208S. doi: 10.1016/0197-2456(89)90058-5. [DOI] [PubMed] [Google Scholar]
  2. Bardsley M. J., Coles J. M. Practical experiences in auditing patient outcomes. Qual Health Care. 1992 Jun;1(2):124–130. doi: 10.1136/qshc.1.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bergner M., Bobbitt R. A., Carter W. B., Gilson B. S. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981 Aug;19(8):787–805. doi: 10.1097/00005650-198108000-00001. [DOI] [PubMed] [Google Scholar]
  4. Bindman A. B., Keane D., Lurie N. Measuring health changes among severely ill patients. The floor phenomenon. Med Care. 1990 Dec;28(12):1142–1152. doi: 10.1097/00005650-199012000-00003. [DOI] [PubMed] [Google Scholar]
  5. Croog S. H., Levine S., Testa M. A., Brown B., Bulpitt C. J., Jenkins C. D., Klerman G. L., Williams G. H. The effects of antihypertensive therapy on the quality of life. N Engl J Med. 1986 Jun 26;314(26):1657–1664. doi: 10.1056/NEJM198606263142602. [DOI] [PubMed] [Google Scholar]
  6. Feinstein A. R. Clinical biostatistics. XLI. Hard science, soft data, and the challenges of choosing clinical variables in research. Clin Pharmacol Ther. 1977 Oct;22(4):485–498. doi: 10.1002/cpt1977224485. [DOI] [PubMed] [Google Scholar]
  7. Fitzpatrick R. M., Bury M., Frank A. O., Donnelly T. Problems in the assessment of outcome in a back pain clinic. Int Disabil Stud. 1987;9(4):161–165. doi: 10.3109/03790798709166354. [DOI] [PubMed] [Google Scholar]
  8. Fitzpatrick R., Ziebland S., Jenkinson C., Mowat A., Mowat A. Importance of sensitivity to change as a criterion for selecting health status measures. Qual Health Care. 1992 Jun;1(2):89–93. doi: 10.1136/qshc.1.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Guyatt G. H., Berman L. B., Townsend M., Pugsley S. O., Chambers L. W. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987 Oct;42(10):773–778. doi: 10.1136/thx.42.10.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Guyatt G., Walter S., Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis. 1987;40(2):171–178. doi: 10.1016/0021-9681(87)90069-5. [DOI] [PubMed] [Google Scholar]
  11. Jenkinson C., Fitzpatrick R. Measurement of health status in patients with chronic illness: comparison of the Nottingham health profile and the general health questionnaire. Fam Pract. 1990 Jun;7(2):121–124. doi: 10.1093/fampra/7.2.121. [DOI] [PubMed] [Google Scholar]
  12. Leigh J. P., Fries J. F. Mortality predictors among 263 patients with rheumatoid arthritis. J Rheumatol. 1991 Sep;18(9):1307–1312. [PubMed] [Google Scholar]
  13. Lomas J., Pickard L., Mohide A. Patient versus clinician item generation for quality-of-life measures. The case of language-disabled adults. Med Care. 1987 Aug;25(8):764–769. doi: 10.1097/00005650-198708000-00009. [DOI] [PubMed] [Google Scholar]
  14. Meenan R. F., Gertman P. M., Mason J. H., Dunaif R. The arthritis impact measurement scales. Further investigations of a health status measure. Arthritis Rheum. 1982 Sep;25(9):1048–1053. doi: 10.1002/art.1780250903. [DOI] [PubMed] [Google Scholar]
  15. Neinstein L. S., Katz B. Contraceptive use in the chronically ill adolescent female: Part I. J Adolesc Health Care. 1986 Mar;7(2):123–133. doi: 10.1016/s0197-0070(86)80008-0. [DOI] [PubMed] [Google Scholar]
  16. Nelson E. C., Berwick D. M. The measurement of health status in clinical practice. Med Care. 1989 Mar;27(3 Suppl):S77–S90. doi: 10.1097/00005650-198903001-00007. [DOI] [PubMed] [Google Scholar]
  17. Nelson E. C., Landgraf J. M., Hays R. D., Wasson J. H., Kirk J. W. The functional status of patients. How can it be measured in physicians' offices? Med Care. 1990 Dec;28(12):1111–1126. [PubMed] [Google Scholar]
  18. Roland M., Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976) 1983 Mar;8(2):141–144. doi: 10.1097/00007632-198303000-00004. [DOI] [PubMed] [Google Scholar]
  19. Rubenstein L. V., Calkins D. R., Young R. T., Cleary P. D., Fink A., Kosecoff J., Jette A. M., Davies A. R., Delbanco T. L., Brook R. H. Improving patient function: a randomized trial of functional disability screening. Ann Intern Med. 1989 Nov 15;111(10):836–842. doi: 10.7326/0003-4819-111-10-836. [DOI] [PubMed] [Google Scholar]
  20. Schumacher M., Olschewski M., Schulgen G. Assessment of quality of life in clinical trials. Stat Med. 1991 Dec;10(12):1915–1930. doi: 10.1002/sim.4780101207. [DOI] [PubMed] [Google Scholar]
  21. Spitzer W. O., Dobson A. J., Hall J., Chesterman E., Levi J., Shepherd R., Battista R. N., Catchlove B. R. Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis. 1981;34(12):585–597. doi: 10.1016/0021-9681(81)90058-8. [DOI] [PubMed] [Google Scholar]
  22. Stewart A. L., Greenfield S., Hays R. D., Wells K., Rogers W. H., Berry S. D., McGlynn E. A., Ware J. E., Jr Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):907–913. [PubMed] [Google Scholar]
  23. Stewart A. L., Hays R. D., Ware J. E., Jr The MOS short-form general health survey. Reliability and validity in a patient population. Med Care. 1988 Jul;26(7):724–735. doi: 10.1097/00005650-198807000-00007. [DOI] [PubMed] [Google Scholar]
  24. Sutherland H. J., Lockwood G. A., Boyd N. F. Ratings of the importance of quality of life variables: therapeutic implications for patients with metastatic breast cancer. J Clin Epidemiol. 1990;43(7):661–666. doi: 10.1016/0895-4356(90)90036-o. [DOI] [PubMed] [Google Scholar]
  25. Tandon P. K., Stander H., Schwarz R. P., Jr Analysis of quality of life data from a randomized, placebo-controlled heart-failure trial. J Clin Epidemiol. 1989;42(10):955–962. doi: 10.1016/0895-4356(89)90160-1. [DOI] [PubMed] [Google Scholar]
  26. Tugwell P., Bombardier C., Buchanan W. W., Goldsmith C., Grace E., Bennett K. J., Williams H. J., Egger M., Alarcon G. S., Guttadauria M. Methotrexate in rheumatoid arthritis. Impact on quality of life assessed by traditional standard-item and individualized patient preference health status questionnaires. Arch Intern Med. 1990 Jan;150(1):59–62. doi: 10.1001/archinte.150.1.59. [DOI] [PubMed] [Google Scholar]
  27. Wolfe F., Cathey M. A. The assessment and prediction of functional disability in rheumatoid arthritis. J Rheumatol. 1991 Sep;18(9):1298–1306. [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES