BMJ 2002;324:1417 ( 15 June )

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Quality of life measurement: bibliographic study of patient assessed health outcome measures

Andrew Garratt, research officer, ^a Louise Schmidt, research officer, ^a Anne Mackintosh, database manager, ^a Ray Fitzpatrick, professor. ^b

^a National Centre for Health Outcomes Development, Unit of Health-Care Epidemiology, Institute of Health Sciences, University of Oxford, Oxford OX3 7LF, ^b Department of Public Health, Institute of Health Sciences, University of Oxford, Oxford OX3 7LF

Correspondence to: A Garratt andrew.garratt{at}uhce.ox.ac.uk

Objectives: To assess the growth of quality of life measures and to examine the availability of measures across specialties.
Design: Systematic searches of electronic databases to identify developmental and evaluative work relating to health outcome measures assessed by patients.
Main outcome measures: Types of measures: disease or population specific, dimension specific, generic, individualised, and utility. Specialties in which measures have been developed and evaluated.
Results: 3921 reports that described the development and evaluation of patient assessed measures met the inclusion criteria. Of those that were classifiable, 1819 (46%) were disease or population specific, 865 (22%) were generic, 690 (18%) were dimension specific, 409 (10%) were utility, and 62 (1%) were individualised measures. During 1990-9 the number of new reports of development and evaluation rose from 144 to 650 per year. Reports of disease specific measures rose exponentially. Over 30% of evaluations were in cancer, rheumatology and musculoskeletal disorders, and older people's health. The generic measuresSF-36, sickness impact profile, and Nottingham health profileaccounted for 612 (16%) reports.
Conclusions: In some specialties there are numerous measures of quality of life and little standardisation. Primary research through the concurrent evaluation of measures and secondary research through structured reviews of measures are prerequisites for standardisation. Recommendations for the selection of patient assessed measures of health outcome are needed.

What is already known on this topic Quality of life measures are increasingly used for measuring health outcomes in evaluative research There is little standardisation in the use of such measures within clinical trials What this study adds There has been exponential growth in reports relating to the development and evaluation of quality of life measures The number of reports varies considerably according to the health problem

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