Mostly About Quality of Life

A welcome development in health-care research is the increasing attention being paid to the quality of life issues in epidemiologic studies and when evaluating competing therapies. A key aspect is the measurement of the effects of symptoms of illness, as well as of the treatment of these symptoms, on well-being, which is a subjective and relative state. Therefore, it is quite appropriate that measurement of improvement or deterioration in quality of life be based on the patient’s perception and self-report. A person who has had severe and disabling angina may perceive improved well-being as a result of treatment if he can walk without pain, whereas a young ski enthusiast may experience marked deterioration if he is unable to ski. For that reason, in studies on this issue, the individual often serves as his or her own control, and the measures used are change scores in some quality of life dimensions from before to after treatment. However, it remains important to have an appropriate control group to compare the changes, because people show changes in these dimensions over time that may be unrelated to the particular treatment being evaluated.