 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 April 1993 | Volume 118 Issue 8 | Pages 622-629
Clinicians and policymakers are recognizing the importance of measuring health-related quality of life (HRQL) to inform patient management and policy decisions. Self- or interviewer-administered questionnaires can be used to measure cross-sectional differences in quality of life between patients at a point in time (discriminative instruments) or longitudinal changes in HRQL within patients during a period of time (evaluative instruments). Both discriminative and evaluative instruments must be valid (really measuring what they are supposed to measure) and have a high ratio of signal to noise (reliability and responsiveness, respectively). Reliable discriminative instruments are able to reproducibly differentiate between persons. Responsive evaluative measures are able to detect important changes in HRQL during a period of time, even if those changes are small. Health-related quality of life measures should also be interpretable—that is, clinicians and policymakers must be able to identify differences in scores that correspond to trivial, small, moderate, and large differences.
Two basic approaches to quality-of-life measurement are available: generic instruments that provide a summary of HRQL; and specific instruments that focus on problems associated with single disease states, patient groups, or areas of function. Generic instruments include health profiles and instruments that generate health utilities. The approaches are not mutually exclusive. Each approach has its strengths and weaknesses and may be suitable for different circumstances. Investigations in HRQL have led to instruments suitable for detecting minimally important effects in clinical trials, for measuring the health of populations, and for providing information for policy decisions.
Author and Article Information
From McMaster University, Hamilton, Ontario, Canada; and the University of Washington, Seattle, Washington.
REVIEW
Measuring Health-related Quality of Life
Requests for Reprints: Gordon H. Guyatt, MD, Room 2C12, McMaster University Health Sciences Centre, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.
Grant Support: Dr. Guyatt is a Career Scientist of the Ontario Ministry of Health.
This article has been cited by other articles:
|
|
 |
|
  J. A. Spertus Evolving Applications for Patient-Centered Health Status Measures Circulation, November 11, 2008; 118(20): 2103 - 2110. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Hatt, D. A. Leske, W. E. Adams, P. A. Kirgis, E. A. Bradley, and J. M. Holmes Quality of Life in Intermittent Exotropia: Child and Parent Concerns Arch Ophthalmol, November 1, 2008; 126(11): 1525 - 1529. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Mather, B. J. Cox, M. W. Enns, and J. Sareen Associations Between Body Weight and Personality Disorders in a Nationally Representative Sample Psychosom Med, November 1, 2008; 70(9): 1012 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. VanBeek Integrating Patient Preferences With Health Utilities: A Variation on Health-Related Quality of Life Arch Dermatol, August 1, 2008; 144(8): 1037 - 1041. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Spertus Assessing patients' improvement in clinical trials BMJ, June 7, 2008; 336(7656): 1258 - 1259. [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Teh, A. M. Kilbourne, J. F. McCarthy, D. Welsh, and F. C. Blow Gender Differences in Health-Related Quality of Life for Veterans With Serious Mental Illness Psychiatr Serv, June 1, 2008; 59(6): 663 - 669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Dawson, H. Doll, I. Boller, R. Fitzpatrick, C. Little, J. Rees, C. Jenkinson, and A. J. Carr The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery J Bone Joint Surg Br, April 1, 2008; 90-B(4): 466 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Suk, D. C. Norvell, B. Hanson, J. R. Dettori, and D. Helfet Evidence-based Orthopaedic Surgery: What Is Evidence Without the Outcomes? J. Am. Acad. Ortho. Surg., March 1, 2008; 16(3): 123 - 129. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. R. Vetter A Clinical Profile of a Cohort of Patients Referred to an Anesthesiology-Based Pediatric Chronic Pain Medicine Program Anesth. Analg., March 1, 2008; 106(3): 786 - 794. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G Regensteiner, W. R Hiatt, J. R Coll, M. H Criqui, D. Treat-Jacobson, M. M McDermott, and A. T Hirsch The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program Vascular Medicine, February 1, 2008; 13(1): 15 - 24. [Abstract] [PDF]
|
|
|
|
 |
|
 N. McCullough and J. Parkes Use of the Child Health Questionnaire in Children with Cerebral Palsy: A Systematic Review and Evaluation of the Psychometric Properties J. Pediatr. Psychol., January 1, 2008; 33(1): 80 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.L. Jones, J.M. Hall, A.H. Balen, and W.L. Ledger Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review Hum. Reprod. Update, January 1, 2008; 14(1): 15 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. K. Hood and T. R. Nansel Commonalities in Effective Behavioral Interventions for Children and Adolescents With Type 1 Diabetes: A Review of Reviews Diabetes Spectr, October 1, 2007; 20(4): 251 - 254. [Full Text] [PDF]
|
|
|
|
 |
|
 I Coulter, S Frewin, G E Krassas, and P Perros Psychological implications of Graves' orbitopathy Eur. J. Endocrinol., August 1, 2007; 157(2): 127 - 131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Naylor, V. R. Hill-Milbourne, S. R. Knoble, K. M. Robinson, K. H. Bowles, and G. Maislin Community-Based Care Model for High-Risk Adults with Severe Disabilities Home Health Care Management Practice, June 1, 2007; 19(4): 255 - 266. [Abstract] [PDF]
|
|
|
|
 |
|
 P. E. Beaule, M. J. Le Duff, and E. Zaragoza Quality of Life Following Femoral Head-Neck Osteochondroplasty for Femoroacetabular Impingement J. Bone Joint Surg. Am., April 1, 2007; 89(4): 773 - 779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. R. Vetter A Primer on Health-Related Quality of Life in Chronic Pain Medicine Anesth. Analg., March 1, 2007; 104(3): 703 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. E. Hartman, F. J. Oort, D. C. Aronson, M. J.G. Hanneman, E. van Heurn, Z. J. de Langen, G. C. Madern, P. N.M.A. Rieu, D. C. van der Zee, N. Looyaard, et al. Explaining Change in Quality of Life of Children and Adolescents With Anorectal Malformations or Hirschsprung Disease Pediatrics, February 1, 2007; 119(2): e374 - e383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Carlson, J. DeVoe, and B. J. Wright Short-term impacts of coverage loss in a medicaid population: early results from a prospective cohort study of the Oregon health plan. Ann. Fam. Med, September 1, 2006; 4(5): 391 - 398. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Saigal, B. Stoskopf, J. Pinelli, D. Streiner, L. Hoult, N. Paneth, and J. Goddeeris Self-Perceived Health-Related Quality of Life of Former Extremely Low Birth Weight Infants at Young Adulthood Pediatrics, September 1, 2006; 118(3): 1140 - 1148. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A S. Pickard and S.-Y. Hung An Update on Evidence of Clinical Pharmacy Services' Impact on Health-Related Quality of Life Ann. Pharmacother., September 1, 2006; 40(9): 1623 - 1634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Watt, M. Groenvold, A. K. Rasmussen, S. J. Bonnema, L. Hegedus, J. B. Bjorner, and U. Feldt-Rasmussen Quality of life in patients with benign thyroid disorders. A review. Eur. J. Endocrinol., April 1, 2006; 154(4): 501 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-R. Lin, H.-F. Hwang, K.-P. Chung, C. Huang, and C.-Y. Chen Rating Scale, Standard Gamble, and Time Trade-off for People With Traumatic Spinal Cord Injuries Physical Therapy, March 1, 2006; 86(3): 337 - 344. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Chen, P. Cohen, S. Kasen, J. G. Johnson, K. Berenson, and K. Gordon Impact of Adolescent Mental Disorders and Physical Illnesses on Quality of Life 17 Years Later Arch Pediatr Adolesc Med, January 1, 2006; 160(1): 93 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Bradley, D. Bradley, and G. B. Bartley Evaluating Health-Related Quality of Life in Ophthalmic Disease: Practical Considerations Arch Ophthalmol, January 1, 2006; 124(1): 121 - 122. [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Trout, D. F. Kallmes, L. A. Gray, B. A. Goodnature, S. L. Everson, B. A. Comstock, and J. G. Jarvik Evaluation of Vertebroplasty with a Validated Outcome Measure: The Roland-Morris Disability Questionnaire AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2652 - 2657. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Brundage, D. Feldman-Stewart, A. Leis, A. Bezjak, L. Degner, K. Velji, L. Zetes-Zanatta, D. Tu, P. Ritvo, and J. Pater Communicating Quality of Life Information to Cancer Patients: A Study of Six Presentation Formats J. Clin. Oncol., October 1, 2005; 23(28): 6949 - 6956. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Leong, K. O. Kong, B. Y. H. Thong, E. T. Koh, T. Y. Lian, C. L. Teh, Y. K. Cheng, H. H. Chng, H. Badsha, W. G. Law, et al. Development and preliminary validation of a systemic lupus erythematosus-specific quality-of-life instrument (SLEQOL) Rheumatology, October 1, 2005; 44(10): 1267 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Solotaroff, J. Devoe, B. J. Wright, J. Smith, J. Boone, T. Edlund, and M. J. Carlson Medicaid programme changes and the chronically ill: early results from a prospective cohort study of the Oregon Health Plan Chronic Illness, September 1, 2005; 1(3): 191 - 205. [Abstract] [PDF]
|
|
|
|
 |
|
 G. J. Kahaly, S. Pitz, G. Hommel, and M. Dittmar Randomized, Single Blind Trial of Intravenous versus Oral Steroid Monotherapy in Graves' Orbitopathy J. Clin. Endocrinol. Metab., September 1, 2005; 90(9): 5234 - 5240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J J Swigris, W G Kuschner, S S Jacobs, S R Wilson, and M K Gould Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review Thorax, July 1, 2005; 60(7): 588 - 594. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Wright, M. J. Carlson, T. Edlund, J. DeVoe, C. Gallia, and J. Smith The Impact Of Increased Cost Sharing On Medicaid Enrollees Health Aff., July 1, 2005; 24(4): 1106 - 1116. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. N. Goldberg, C. J. Grassi, J. F. Cardella, J. W. Charboneau, G. D. Dodd II, D. E. Dupuy, D. Gervais, A. R. Gillams, R. A. Kane, F. T. Lee Jr, et al. Image-guided Tumor Ablation: Standardization of Terminology and Reporting Criteria Radiology, June 1, 2005; 235(3): 728 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-B. Wasserfallen, S. Ostermann, S. Leyvraz, and R. Stupp Cost of temozolomide therapy and global care for recurrent malignant gliomas followed until death Neuro-oncol, April 1, 2005; 7(2): 189 - 195. [Abstract] [PDF]
|
|
|
|
|
|
M.-F. Demierre, A. Tien, and D. Miller Health-Related Quality-of-Life Assessment in Patients With Cutaneous T-Cell Lymphoma Arch Dermatol, March 1, 2005; 141(3): 325 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J D Fisk, M G Brown, I S Sketris, L M Metz, T J Murray, and K J Stadnyk A comparison of health utility measures for the evaluation of multiple sclerosis treatments J. Neurol. Neurosurg. Psychiatry, January 1, 2005; 76(1): 58 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Carone and C F Donner Impact of long-term ventilation on patients-health status Chronic Respiratory Disease, January 1, 2005; 2(1): 29 - 33. [Abstract] [PDF]
|
|
|
|
|
|
A. S. Davies and A. Williams Measurement of dyspnoea is measuring what? Chronic Respiratory Disease, January 1, 2005; 2(1): 53 - 53. [PDF]
|
|
|
|
 |
|
 J. J. Swigris, M. K. Gould, and S. R. Wilson Health-Related Quality of Life Among Patients With Idiopathic Pulmonary Fibrosis Chest, January 1, 2005; 127(1): 284 - 294. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Padua, C. Rendeli, E. Ausili, I. Aprile, P. Caliandro, P. Tonali, and E. Salvaggio Relationship Between the Clinical-Neurophysiologic Pattern, Disability, and Quality of Life in Adolescents With Spina Bifida J Child Neurol, December 1, 2004; 19(12): 952 - 957. [Abstract] [PDF]
|
|
|
|
 |
|
 H Dagfinrud, A M Mengshoel, K B Hagen, J H Loge, and T K Kvien Health status of patients with ankylosing spondylitis: a comparison with the general population Ann Rheum Dis, December 1, 2004; 63(12): 1605 - 1610. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Mandelblatt, C. Armetta, K. R. Yabroff, W. Liang, and W. Lawrence Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000 J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 8 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Pickard, L.-A. Topfer, and D. H. Feeny A Structured Review of Studies on Health-Related Quality of Life and Economic Evaluation in Pediatric Acute Lymphoblastic Leukemia J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 102 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. R. Yabroff, W. F. Lawrence, S. Clauser, W. W. Davis, and M. L. Brown Burden of Illness in Cancer Survivors: Findings From a Population-Based National Sample J Natl Cancer Inst, September 1, 2004; 96(17): 1322 - 1330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. P. Sands, P. Ferreira, A. L. Stewart, M. Brod, and K. Yaffe What Explains Differences Between Dementia Patients' and Their Caregivers' Ratings of Patients' Quality of Life? Am J Geriatr Psychiatry, June 1, 2004; 12(3): 272 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W W Flemons Measuring quality of life in patients with sleep apnoea: whose life is it anyway? Thorax, June 1, 2004; 59(6): 457 - 458. [Full Text] [PDF]
|
|
|
|
|
|
Y Lacasse, M-P Bureau, and F Series A new standardised and self-administered quality of life questionnaire specific to obstructive sleep apnoea Thorax, June 1, 2004; 59(6): 494 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. W. Torrance, P. Tugwell, S. Amorosi, E. Chartash, and N. Sengupta Improvement in health utility among patients with rheumatoid arthritis treated with adalimumab (a human anti-TNF monoclonal antibody) plus methotrexate Rheumatology, June 1, 2004; 43(6): 712 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Ethgen, O. Bruyere, F. Richy, C. Dardennes, and J.-Y. Reginster Health-Related Quality of Life in Total Hip and Total Knee Arthroplasty. A Qualitative and Systematic Review of the Literature J. Bone Joint Surg. Am., May 1, 2004; 86(5): 963 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E J Irvine Quality of life assessment in gastro-oesophageal reflux disease Gut, May 1, 2004; 53(suppl_4): iv35 - iv39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S D M Bot, C B Terwee, D A W M van der Windt, L M Bouter, J Dekker, and H C W de Vet Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature Ann Rheum Dis, April 1, 2004; 63(4): 335 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.L. Severens, J.B. Prins, G.J. van der Wilt, J.W.M. van der Meer, and G. Bleijenberg Cost-effectiveness of cognitive behaviour therapy for patients with chronic fatigue syndrome QJM, March 1, 2004; 97(3): 153 - 161. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Cox, J. F. Donohue, C. D. Brown, Y. P. Kataria, and M. A. Judson Health-Related Quality of Life of Persons With Sarcoidosis Chest, March 1, 2004; 125(3): 997 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P M Meek Measurement of dyspnea in chronic obstructive pulmonary disease: what is the tool telling you? Chronic Respiratory Disease, January 1, 2004; 1(1): 29 - 37. [Abstract] [PDF]
|
|
|
|
 |
|
 H. J. Schunemann, E. Stahl, P. Austin, E. Akl, D. Armstrong, and G. H. Guyatt A Comparison of Narrative and Table Formats for Presenting Hypothetical Health States to Patients with Gastrointestinal or Pulmonary Disease Med Decis Making, January 1, 2004; 24(1): 53 - 60. [Abstract] [PDF]
|
|
|
|
|
|
T. E. Burroughs, R. Desikan, B. M. Waterman, D. Gilin, and J. McGill Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory Diabetes Spectr, January 1, 2004; 17(1): 41 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. L. Maddigan, D. H. Feeny, and J. A. Johnson A Comparison of the Health Utilities Indices Mark 2 and Mark 3 in Type 2 Diabetes Med Decis Making, November 1, 2003; 23(6): 489 - 501. [Abstract] [PDF]
|
|
|
|
 |
|
 P.-E. Falcoz, S. Chocron, L. Stoica, D. Kaili, M. Puyraveau, M. Mercier, and J.-P. Etievent Open heart surgery: one-year self-assessment of quality of life and functional outcome Ann. Thorac. Surg., November 1, 2003; 76(5): 1598 - 1604. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. Phillips, J. L. Alexander, V. Pepin, and C. Riley Cardiac Rehabilitation Patient Versus Proxy Quality-of-Life Perceptions Clin Nurs Res, August 1, 2003; 12(3): 282 - 293. [Abstract] [PDF]
|
|
|
|
 |
|
 C. E. Cox, J. F. Donohue, C. D. Brown, Y. P. Kataria, and M. A. Judson The Sarcoidosis Health Que |
Article
