The Unanswered Challenges in Measuring Quality of Life

Abstract

The measurement of health status and quality of life is a major challenge facing health researchers. The task is to locate individuals within life space and show how health-related events impact on their life space. The specific quest is for measures sensitive to changes in health status/quality of life that can be attributed to health problems and interventions. Pharmaceutical companies must demonstrate, to the agencies responsible for approving drugs, the impact of their products on the quantity and quality of life. Researchers need responsive, sensible instruments for assessing the efficacy and effectiveness of interventions in randomized controlled trials and clinical studies. Providers, managers, and policy-makers need to know the cost-effectiveness of interventions and programs. Outcomes information systems are introducing measures into managed care in the United States, for purposes of both management and marketing. National organizations in the United States, such as the National Council for Quality Assurance and the Foundation of Accountability, are requiring report cards for managing care that include assessments of outcome. The creation, adaptation, and testing of measures has been a growth industry in Europe and North America over the past 20 years, as evidenced in publications, presentations at conferences, peer-reviewed grants, industry funding, graduate theses, seminars, workshops, consulting activities, and the commercialization of specific products. International collaborations and networks of providers are being formed to create new measures. Researchers and commercial enterprises compete for their share of the academic and private markets.