When there exists a variable external to the measure against which the scores can be checked, that variable can be used as a criterion to judge the measures. For example, the quality-of-life scores should differentiate patients dying of cancer, patients in intensive care, outpatients with chronic diseases, and healthy individuals, even though there may be substantial overlaps in the distributions of scores. Spitzer (1987) includes the burden of symptoms in his operational definition of health. He would restrict the assessment of the attributes of health to those who are definitely sick. He sees little point in extending the studies of quality of life in health care to the ostensibly healthy, but few writers in the field agree with this point of view.

Validity

Sets of physicians or mental health professionals assessed 75 cancer patients. Pearson correlations were 0.89 and Kappa statistics were 59 percent (Schag et al. 1984). One hundred patients completed 335 sets of LASA forms that included 21 LASA items; in addition the same 100 patients were rated on the QLI administered by a social worker, the QLI completed by patients, and a single well-being (LASA) item. Investigators found that the highest correlations were between social workers’ and patients’ responses to the QLI. We also refer readers to the Clearinghouse on Health Indexes of the National Center for Health Statistics of the U.S. The Clearinghouse publishes a quarterly Bibliography on Health Indexes (editor, P. Erickson) that provides information on the reliability, validity, and sensitivity of various measures of health status.

Researchers commonly exclude cognitive functioning from consideration in studies of quality of life. Except for diseases and therapies that obviously diminish mental capacity, investigators usually assume that the cognitive abilities of individuals are unaffected by episodes of illness and care. One may test this assumption by including tests of cognitive functioning, as did Croog et al. (1986) in their study of antihypertensive medications.

1. In these circumstances, researchers may use quality-of-life measures completed by other persons such as a responsible clinician, spouse, close friend, or relative of the patient.
2. The utility assessment of health states and quality of life has arisen from a theoretical perspective and methodology that are distinct from those employed by behavioral and clinical scientists.
3. The different ways that quality of life is defined by institutions, therefore, shape how these organizations work for its improvement as a whole.
4. Three hundred and eight patients with advanced breast cancer were randomized to continuous or intermittent chemotherapy.

Review for Functional Living Index—Cancer

Livability has a long history and tradition in urban design, and neighborhoods design standards such as LEED-ND are often used in an attempt to influence livability. First, this study was designed as a snapshot and aimed to analyze and describe QOL research in one random week. Admittedly, a snapshot of a single week might not be representative of QOL research in general. It is possible that similar studies quality of life definition may have been published in other languages than English. One of the critiques of QOL research is the lack of conceptual clarity and a uniform definition of QOL 6. Using a clearer and definitive definition of QOL research and research that includes QOL measures may increase the conceptual understanding, which will help researchers plan and conduct more rigorous QOL research studies 6.

Preconditions for good health, such as adequate nutrition and professional care, are seldom mixed up with the concept of health. In the first case, the quality is in the environment in which one lives; in the latter, it is in the individual. Using this definition, the World Bank works towards improving quality of life through the stated goal of lowering poverty and helping people afford a better quality of life. The Social Progress Index measures the extent to which countries provide for the social and environmental needs of their citizens. Fifty-two indicators in the areas of basic human needs, foundations of wellbeing, and opportunity show the relative performance of nations. The index uses outcome measures when there is sufficient data available or the closest possible proxies.

Quality of Life and Technology Assessment: Monograph of the Council on Health Care Technology.

LASA forms included items for global well-being (for example, well-being, mood, appetite) and disease-specific conditions (such as, pain, nausea, vomiting). Both ECOG scores and the LASA scores for general well-being showed parallel and marked deterioration during the period of radiotherapy with subsequent improvement. First, although investigators have focused on the clinical relevance of the measures, minimal attention has been paid to the conceptual underpinnings of quality of life or the theoretical bases for the particular measures.

As Ware (1987) noted “jobs, housing, schools, and the neighborhood are not attributes of an individual’s health, and they are well outside the purview of the health care system.” Academic interest in quality of life grew after World War II, when there was increasing awareness and recognition of social inequalities. This provided the impetus for social indicators research and subsequently for research on subjective well-being and quality of life. The patient’s view of his or her own health had long played some role in medical consultation; however, in terms of the health care literature, researchers did not begin collecting and reporting such data systematically until the 1960s. Random samples of individuals in a community gave preference ratings to the descriptions on a continuum ranging from 0 for death to 1 for completely well. A model for preference structure assigned weights to each level of functioning and symptoms/problem complex.

The majority of the included studies measured HRQOL, and only few articles distinguished between the terms. Cuerda et al. 20 argued for instance that they preferred to study HRQOL because it is a dynamic variable, which evaluates the subjective influence of health status, health care, and preventive health activities 20. The terms health, HRQOL, and QOL are often used interchangeably in the literature. However, these terms have different definitions and intended use, and it is problematic that some researchers fail to distinguish between them. Further, it is debated whether many of the instruments used to measure HRQOL actually measure self-perceived health status and that the term (HR)QOL is unjustified 21.

Concurrent criterion validity refers to the ability of a measure to differentiate between groups at the time the measure is applied. Predictive criterion validity refers to the ability to use these scores to predict future health-related events and states. The stability of a scale or factor score is assessed by correlating the scores of subjects with the scores obtained in testing at another time. As Bohrnstedt (1981) has noted, the test-retest coefficient can be influenced by true changes in scores. The interpretation of the coefficient of stability is not always straightforward. Measures may focus on the symptoms, complaints, disabilities, and disruptions in life that are specific to the clinical condition under study.