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. 1999 Mar;8(1):22–29. doi: 10.1136/qshc.8.1.22

Patient centred assessment of quality of life for patients with four common conditions

D A Ruta, A M Garratt, I T Russell
PMCID: PMC2483625  PMID: 10557665

Abstract

OBJECTIVES: To assess the reliability, validity, and responsiveness of a new quality of life measure, the patient generated index (PGI) of quality of life, in patients with four common clinical conditions. DESIGN: Prospective one year follow up study. SETTING: Outpatient departments and four general practices in Grampian, Scotland. SUBJECTS: 1746 patients consulting a general practitioner in one of four practices, or referred to outpatients from all Grampian practices over a four month period, with low back pain, menorrhagia, suspected peptic ulcer, and varicose veins. MAIN OUTCOME MEASURES: Postal questionnaire including the PGI, SF-36 health survey, and clinically derived condition specific measures of disease severity. RESULTS: Test-retest reliability was satisfactory for group comparisons (intraclass correlation coefficient 0.65). Validity was confirmed by the observed association of the PGI with the SF-36, condition specific instruments, and sociodemographic variables. For low back pain, the PGI and the SF- 36 pain scale were found to be most responsive to clinical change. For patients with menorrhagia and suspected peptic ulcer, only the condition specific instruments detected larger changes than the PGI. CONCLUSIONS: It is possible to develop a patient generated index of quality of life that not only assesses the extent to which patients' expectations are matched by reality but also satisfies criteria of reliability and responsiveness to change. Further work is required to make the PGI more acceptable and meaningful to patients, but it is believed that it offers an exciting new approach to the evaluation of medical care.

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Selected References

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  1. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  2. Brickman P., Coates D., Janoff-Bulman R. Lottery winners and accident victims: is happiness relative? J Pers Soc Psychol. 1978 Aug;36(8):917–927. doi: 10.1037//0022-3514.36.8.917. [DOI] [PubMed] [Google Scholar]
  3. Calman K. C. Quality of life in cancer patients--an hypothesis. J Med Ethics. 1984 Sep;10(3):124–127. doi: 10.1136/jme.10.3.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Garratt A. M., Macdonald L. M., Ruta D. A., Russell I. T., Buckingham J. K., Krukowski Z. H. Towards measurement of outcome for patients with varicose veins. Qual Health Care. 1993 Mar;2(1):5–10. doi: 10.1136/qshc.2.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Garratt A. M., Ruta D. A., Abdalla M. I., Buckingham J. K., Russell I. T. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993 May 29;306(6890):1440–1444. doi: 10.1136/bmj.306.6890.1440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Garratt A. M., Ruta D. A., Abdalla M. I., Russell I. T. Responsiveness of the SF-36 and a condition-specific measure of health for patients with varicose veins. Qual Life Res. 1996 Apr;5(2):223–234. doi: 10.1007/BF00434744. [DOI] [PubMed] [Google Scholar]
  7. Garratt A. M., Ruta D. A., Abdalla M. I., Russell I. T. SF 36 health survey questionnaire: II. Responsiveness to changes in health status in four common clinical conditions. Qual Health Care. 1994 Dec;3(4):186–192. doi: 10.1136/qshc.3.4.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Garratt A. M., Ruta D. A., Russell I., Macleod K., Brunt P., McKinlay A., Mowat A., Sinclair T. Developing a condition-specific measure of health for patients with dyspepsia and ulcer-related symptoms. J Clin Epidemiol. 1996 May;49(5):565–571. doi: 10.1016/0895-4356(95)00584-6. [DOI] [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. Herd R. M., Tidman M. J., Ruta D. A., Hunter J. A. Measurement of quality of life in atopic dermatitis: correlation and validation of two different methods. Br J Dermatol. 1997 Apr;136(4):502–507. [PubMed] [Google Scholar]
  12. Jenkinson C., Stradling J., Petersen S. How should we evaluate health status? A comparison of three methods in patients presenting with obstructive sleep apnoea. Qual Life Res. 1998 Feb;7(2):95–100. doi: 10.1023/a:1008845123907. [DOI] [PubMed] [Google Scholar]
  13. Katz J. N., Larson M. G., Phillips C. B., Fossel A. H., Liang M. H. Comparative measurement sensitivity of short and longer health status instruments. Med Care. 1992 Oct;30(10):917–925. doi: 10.1097/00005650-199210000-00004. [DOI] [PubMed] [Google Scholar]
  14. Liang M. H., Larson M. G., Cullen K. E., Schwartz J. A. Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. Arthritis Rheum. 1985 May;28(5):542–547. doi: 10.1002/art.1780280513. [DOI] [PubMed] [Google Scholar]
  15. Ruta D. A., Garratt A. M., Chadha Y. C., Flett G. M., Hall M. H., Russell I. T. Assessment of patients with menorrhagia: how valid is a structured clinical history as a measure of health status? Qual Life Res. 1995 Feb;4(1):33–40. doi: 10.1007/BF00434381. [DOI] [PubMed] [Google Scholar]
  16. Ruta D. A., Garratt A. M., Wardlaw D., Russell I. T. Developing a valid and reliable measure of health outcome for patients with low back pain. Spine (Phila Pa 1976) 1994 Sep 1;19(17):1887–1896. doi: 10.1097/00007632-199409000-00004. [DOI] [PubMed] [Google Scholar]
  17. Ware J. E., Jr, Sherbourne C. D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed] [Google Scholar]

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