Table 2. QoL therapy procedures showing the best possible effectiveness for the five therapeutic options to cure diseased QoL in the context of the care pathway.

Procedure	1. Physiotherapy	2. Psychotherapy	3. Social support	4. Pain therapy	5. Nutrition and fitness
Definition of therapeutic option and methodsa	Physical decongestive therapy of upper limb by manual lymph drainage with sequential compression therapy	Individual, experiential psychotherapy and cognitive behavioural interventions for adjustment disorders	Network nodes for social counselling (financial security, well-being, partnership, children, homecare, profession) organised in quality circle	Combination of drugs (WHO analgesic ladder) with non-drug measures, for example, psychotherapy and disease-modifying therapies	Combination of self-help groups: counselling for diet and ambulatory sports training programmes, all enrolled in quality circles
Level of evidence for an effective outcome measureb	1 Questionable effective (Preston et al, 2009)	1 Effective for QoL (Newell et al, 2002)	4 GCP Effectiveness not tested	1 Effective for pain (Hanks et al, 2001)	4 GCP Effectiveness not tested (Beliveau and Gingras, 2005)
Methodological standard achieved in local consensus of recommendationsc	Formal consensus, Nominal Group Process (Lorenz et al, 2001)	Informal consensus, decisions, cases analysed in quality circle	Informal consensus within quality circle	Informal consensus, locally tailored guidelines, in quality circle	Informal consensus, developed only within QoL unit

Abbreviations: GCP=good clinical practice; QoL=quality of life.

General sources of information (Lorenz et al, 2001).

^aGerman national guideline for breast cancer (http://www.AWMF.de) in 2009.

^bScottish Intercollegiate Guidelines Network (SIGN) grading system in 1999.

^cGerman guideline manual in 2001 (Lorenz et al, 2001).