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January 4, 1995, Vol 273, No. 1 >
ARTICLE | January 4, 1995

Linking Clinical Variables With Health-Related Quality of Life: Title and subTitle BreakA Conceptual Model of Patient Outcomes FREE

Ira B. Wilson, MD, MSc; Paul D. Cleary, PhD
[+] Author Affiliations

Reprint requests to the Department of Health Care Policy, Harvard Medical School, 25 Shattuck St, Parcel B, First Floor, Boston, MA 02115 (Dr Cleary).


JAMA. 1995;273(1):59-65. doi:10.1001/jama.1995.03520250075037
Text Size: A A A
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Article
References

HEALTH-related quality of life (HRQL) is increasingly used as an outcome in clinical trials, effectiveness research, and research on quality of care. Factors that have facilitated this increased usage include the accumulating evidence that measures of HRQL are valid and "reliable,"1 the publication of several large clinical trials showing that these outcome measures are responsive to important clinical changes,2-5 and the successful development and testing of shorter instruments that are easier to understand and administer.6-13 Because these measures describe or characterize what the patient has experienced as the result of medical care, they are useful and important supplements to traditional physiological or biological measures of health status.

Given this improved ability to assess patients' health status, how can physicians and health care systems intervene to improve HRQL? Implicit in the use of measures of HRQL in clinical trials and in effectiveness research is the concept that clinical

REFERENCES

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4 +
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Cleary PD, Epstein AM, Oster G, et al.  Health-related quality of life among patients undergoing percutaneous transluminal coronary angioplasty. Med Care . 1991;;29:939-950.
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Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires . New York, NY: Oxford University Press; 1987;.
2 +
Croog SH, Levine S, Testa MA, et al.  The effects of antihypertensive therapy on the quality of life. N Engl J Med . 1986;;314:1657-1664.
3 +
Bombardier C, Ware J, Russell IJ, et al.  Auranofin therapy and quality of life in patients with rheumatoid arthritis. Am J Med . 1986;;81:565-578.
4 +
Canadian Erythropoietin Study Group.  Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. BMJ . 1990;;300:573-578.
5 +
Cleary PD, Epstein AM, Oster G, et al.  Health-related quality of life among patients undergoing percutaneous transluminal coronary angioplasty. Med Care . 1991;;29:939-950.
6 +
Parkerson GR, Broadhead WE, Tse CJ.  The Duke Health Profile: a 17-item measure of health and dysfunction. Med Care . 1990;;28:1056-1072.
7 +
Hunt SM, McEwen J, McKenna SP.  Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract . 1985;;35:185-188.
8 +
Nelson EC, Wasson JH, Krik JW.  Assessment of function in routine clinical practice: description of the COOP chart method and preliminary findings. J Chronic Dis . 1987;;40( (suppl 1) ):55S-63S.
9 +
Stewart AL, Hays RD, Ware JE Jr.  The MOS short-form general health survey: reliability and validity in a patient population. Med Care . 1988;; 26:724-735.
10 +
McHorney CA, Ware JE, Rogers W, Raczek AE, Lu JFR.  The validity and relative precision of MOS short- and long-form health status scales and Dartmouth COOP charts. Med Care . 1992;;30:MS253-MS265.
11 +
Ware JE, Sherbourne CD.  The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection. Med Care . 1992;;30: 473-483.
12 +
McHorney CA, Ware JE Jr, Raczek AE.  The MOS 36-item short-form health survey (SF-36), II: psychometric and clinical tests of validity in measuring physical and mental health conditions. Med Care . 1993;;31:247-263.
13 +
McHorney CA, Ware JE, Lu JFR, Sherbourne CD.  The MOS short-form health survey (SF-36), III: tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care . 1994;;32:40-66.
14 +
Bergner M.  Measurement of health status. Med Care . 1985;;23:696-704.
15 +
Nagi S.  Some conceptual issues in disability and rehabilitation.  In: Sussman MB, ed. Sociology and Rehabilitation . Washington, DC: American Sociological Association; 1965;.
16 +
Read JL, Quinn RJ, Hoefer MA.  Measuring overall health: an evaluation of three important approaches. J Chronic Dis . 1987;;40:7S-21S.
17 +
Patrick DL, Bergner M.  Measurement of health status in the 1990s. Annu Rev Public Health . 1990;; 11:165-183.
18 +
Verbrugge LM.  Physical and social disability in adults.  In: Hibbard H, Nutting PA, Grady ML, eds. Primary Care Research: Theory and Methods . Washington, DC: US Dept of Health and Human Services; 1991;:31-53.
19 +
Johnson RJ, Wolinsky FD.  The structure of health status among older adults: disease, disability, functional limitation, and perceived health. J Health Soc Behav . 1993;;34:105-121.
20 +
Andrews FM, Withey SB. Social Indicators of Well-Being: Americans' Perceptions of Life Quality . New York, NY: Plenum Press; 1976;.
21 +
Berg RL, Hallauer DS, Berk SN.  Neglected aspects of the quality of life. Health Serv Res . 1976;; 11:391-395.
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