Future Issues in the Use of Health Status Assessment Measures in Clinical Settings

Abstract

The author focuses on 3 major threats to the validity and meaningfulness of Health Related Quality of Life (HRQOL) measures. The first of these threats is that of case mix, sometimes referred to as severity of illness, but in reality encompassing all the confounders that would bias a relationship between the treatment (defined broadly as a drug, an educational program, a geographic area, a type of provider, a type of health system, a type of payment, any independent variable) and the outcome, HRQOL. This factor addresses the non specificity of the HRQOL measures. The 2nd issue is sensitivity. The final issue surrounds the link between process and outcome. The central question of this paper is how valid these measures are in their various applications to medical clinical topics such as the success of a drug in AIDS or the success of surgery in cancer. The corollary aim of this paper is to examine ways to retain the central principles of HRQOL measures, but to make them valid and fulfill their purpose in the increasing variety of medical situations in which the generic measures of HRQOL fail to reflect the care provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved)