1. Hermann P. G. Schneider, Alastair H. MacLennan and David Feeny
Quality of life
Hermann P. G. Schneider,
Alastair H. MacLennan and David Feeny

2. A definition of health-related quality of life
HRQOL
represents those parts of quality of life that directly relate to an individual’s health
includes the domains of physical, psychological, social, spiritual, and role functioning, as well as general well-being
Spilker and Revicki , 1996

3. Levels of quality of life
Components of each domain
Broad domains Physical, Psychological, Economic, Spiritual, Social
Overall assessment of well-being
In their totality, these three levels constitute the scope of quality of life
Cramer & Spilker , 1998

4. Rationale for using health-related quality of life measures
Goal of therapy is to make patients feel better
Physiological measures may change without people feeling better
People may feel better without measurable change in physiological function
Trade-offs between treatment effects and side-effects
The output of the health-care system is quality-adjusted survival / health-related quality of life. Why not measure it?
Guyatt, Feeny, Patrick, 1993

5. Assessment of measures of HRQOL
Acceptability
Burden
Reliability
Validity
Responsiveness
Interpretability
Usefulness
Feeny et al., 1999

6. Most widely used measures within 3921 reports
Instrument
No. of records
SF-36
408
WHOQOL 24
Sickness Impact Profile
111
Healthy Years Equivalent
Nottingham Health Profile 93
Beck Depression Inventory 23
EORTC QLQ-C30 82
Asthma Quality of Life Questionnaire 21
QALY 79
McGill Pain Questionnaire 19
EuroQOL 77
WOMAC 18
Health Assessment Questionnaire 62
Hospital Anxiety and Depression Scale
Arthritis Impact Measurement Scales 59
Duke Health Profile 17
Quality of Wellbeing Scale 53
SF-12 15
General Health Questionnaire 43
Psychological General Wellbeing Scale
Health Utilities Index 41
St George‘s Respiratory Disease Questionnaire
COOP Charts 33
MOS-HIV 14
Functional Assessment of Cancer 32
Rotterdam Symptom Check List
Garratt et al., 2002

7. The EuroQOL Instrument
Best imaginable health state
Mobility
I have no problem in walking about
I have some problems in walking about
I am confined to bed
Self-care
I have no problems with self-care
I have some problems washing or dressing myself
I am unable to wash or dress myself
Usual activities
I have no problems with performing my usual activities (e.g. work , study , housework , family or leisure activities)
I have some problems with performing my usual activities
I am unable to perform my usual activities
Pain / discomfort
I have no pain or discomfort
I have moderate pain or discomfort
I have extreme pain or discomfort
Anxiety / depression
I am not anxious or depressed
I am moderately anxious or depressed
I am extremely anxious or depressed
Worst imaginable health state
Kind P, 1996

8. Health-related quality of life Issues in menopause and aging
Importance of placebo effect in studies on symptoms
Lack of standardization of reporting of symptoms
Few studies consider HRQOL impact on partner
Specific instruments for menopause and aging
Generic instrument to capture chronic conditions and side-effects
Utility measures to reflect preferences of patients and community
Feeny, 2006