EDITOR—Sanders et al's bibliographic study on the frequency and detail of reporting on quality of life data in randomised controlled trials listed in the Cochrane Controlled Trials Register is disturbing.1 Despite increasing emphasis on patient centred outcomes in all aspects of clinical practice and research, less than 5% of trials reported on quality of life and even fewer comprehensively reported the quality of data using well validated, familiar instruments.

Deyo and Patrick discussed methodological, attitudinal, and conceptual barriers to the use of quality of life assessments in research in 1989.2 They noted the paucity of information regarding the responsiveness, reliability, validity, and psychometric characteristics of most instruments. In the 1980s many authors noted the problem of a confusing array of instruments, including scales with the same purpose. 2 3 Feinstein et al noted …