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April 16, 1997, Vol 277, No. 15 >
ARTICLE | April 16, 1997

Users' Guides to the Medical Literature: Title and subTitle BreakXII. How to Use Articles About Health-Related Quality of Life FREE

Gordon H. Guyatt, MD, MSc; C. David Naylor, MD, MSc, DPhil; Elizabeth Juniper, MCSP, MSc; Daren K. Heyland, MD; Roman Jaeschke, MD, MSc; Deborah J. Cook, MD, MSc
[+] Author Affiliations

The original list of members (with affiliations) appears in the first article of this series (JAMA. 1993;270: 2093-2095). A list of new members appears in the 10th article of the series (JAMA. 1996;275:1435-1439). The following members contributed to this article: Paul Glasziou, MB, PhD; Virginia Moyer, MD, MPH; and Peter Tugwell, MD, MSc.

Reprints: Gordon H. Guyatt, MD, MSc, McMaster University Health Sciences Centre, 1200 Main St W, Room 2C12, Hamilton, Ontario, Canada L8N 3Z5.

Users' Guides to the Medical Literature section editor: Drummond Rennie, MD, Deputy Editor (West), JAMA.


JAMA. 1997;277(15):1232-1237. doi:10.1001/jama.1997.03540390062037
Text Size: A A A
Published online
Article
References

CLINICAL SCENARIO  You are a physician following a 35-year-old man who has had active Crohn disease for 8 years. The symptoms were severe enough to require resectional surgery 4 years ago, and despite treatment with sulfasalazine and metronidazole, the patient has had active disease requiring oral steroids for the last 2 years. Repeated attempts to decrease the prednisone have failed, and the patient has required doses of greater than 15 mg per day to control symptoms. You are impressed by both the methods and results of a recent article1 documenting that such patients benefit from oral methotrexate and suggest to the patient that he consider this medication. When you explain some of the risks of methotrexate, particularly potential liver toxicity, the patient is hesitant. How much better, he asks, am I likely to feel while taking this medication?

INTRODUCTION  There are 3 reasons we offer treatment to our patients.

REFERENCES

1 +
Feagan BG, Rochon J, Fedorak RN, et al.  Methotrexate for the treatment of Crohn's disease: the North American Crohn's Study Group Investigators . N Engl J Med . 1995;;332:292-297.
2 +
Guyatt GH, Feeny DH, Patrick DL.  Measuring health-related quality of life: basic sciences review . Ann Intern Med . 1993;;70:225-230.
3 +
Gill TM, Feinstein AR.  A critical appraisal of the quality of quality-of-life measurements . JAMA . 1994;;272:619-626.
4 +
Wilson IB, Cleary PD.  Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes . JAMA . 1995;;273:59-65.
5 +
Guyatt GH, Cook DJ.  Health status, quality of life, and the individual . JAMA . 1994;;272:630-631.
6 +
Nocturnal Oxygen Therapy Trial Group.  Continuous or nocturnal oxygen therapy to hypoxemic chronic obstructive lung disease . Ann Intern Med . 1980;;93:391-398.
7 +
Heaton RK, Grant I, McSweeney AJ, Adams KM, Petty TL.  Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease . Arch Intern Med . 1983;;143:1941-1947.
8 +
Mulrow CD, Mulrow JP, Linn WD, Aguilar C, Ramirez G.  Relative efficacy of vasodilator therapy in chronic congestive heart failure: implications of randomized trials . JAMA . 1988;;259:3422-3426.
9 +
Packer M, Carver JR, Rodeheffer RJ, et al.  Effect of oral milrinone on mortality in severe chronic heart failure: the PROMISE Study Research Group . N Engl J Med . 1991;;325:1468-1475.
10 +
Pak CY, Sakhaee K, Piziak V, et al.  Slow-release sodium fluoride in the management of post-menopausal osteoporosis . Ann Intern Med . 1994;; 120:625-632.
11 +
Cook DJ, Guyatt GH, Adachi JD, et al.  Quality of life issues in women with vertebral fractures due to osteoporosis . Arthritis Rheum . 1993;;36:750-756.
12 +
Guyatt GH, Thompson PJ, Berman LB, et al.  How should we measure function in patients with chronic heart and lung disease? J Chronic Dis . 1985;; 38:517-524.
13 +
Mahler DA, Weinberg DH, Wells CK, Feinstein AR.  The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes . Chest . 1984;;85:751-758.
14 +
Rector TS, Kubo SH, Cohn JN.  Patients' self-assessment of their congestive heart failure, II: content, reliability and validity of a new measure—the Minnesota Living With Heart Failure Questionnaire . Heart Failure . 1987;;3:198-209.
15 +
Juniper EF, Guyatt GH, Ferrie PJ, Griffith LE.  Measuring quality of life in asthma . Am Rev Respir Dis . 1993;;147:468-479.
16 +
Wiklund I, Comerford MB, Dimenas E.  The relationship between exercise tolerance and quality of life in angina pectoris . Clin Cardiol . 1991;;14:204-208.
17 +
Osteoporosis Quality of Life Research Group. Measuring quality of life in women with osteoporosis. J Bone Miner Res. In press.
18 +
Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW.  A measure of quality of life for clinical trials in chronic lung disease . Thorax . 1987;; 42:773-778.
19 +
Goldstein RS, Gort EH, Guyatt GH, Stubbing D, Avendano MA.  Prospective randomized controlled trial of respiratory rehabilitation . Lancet . 1994;;344: 1394-1397.
20 +
Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG.  A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia: the Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate . N Engl J Med . 1995;;332:75-79.
21 +
Guyatt GH, Mitchell A, Irvine EJ, et al.  A new measure of health status for clinical trials in inflammatory bowel disease . Gastroenterology . 1989;;96:804-810.
22 +
Kirshner B, Guyatt GH.  A methodologic framework for assessing health indices . J Chronic Dis . 1985;;38:27-36.
23 +
Guyatt GH, Kirshner B, Jaeschke R.  Measuring health status: what are the necessary measurement properties? J Clin Epidemiol . 1992;;45:1341-1345.
24 +
De Weerdt I, Visser AP, Kok GI, de Weerdt 0, Van der Veen EA.  Randomized controlled multicentre evaluation of an education programme for insulin-treated diabetic patients: effects on metabolic control, quality of life, and costs of therapy . Diabet Med . 1991;;8:338-345.
25 +
Irvine EJ, Feagan B, Rochon J, et al.  Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease . Gastroenterology . 1994;;106:287-296.
26 +
Greenberg GR, Feagan BG, Martin F, et al.  Oral budesonide for active Crohn's disease: Canadian Inflammatory Bowel Disease Study Group . N Engl J Med . 1994;;331:836-841.
27 +
Salonen R, Ashford E, Dahlof C, et al.  Intranasal sumatriptan for the acute treatment of migraine . J Neurol . 1994;;241:463-469.
28 +
Mathew NT, Saper JR, Silberstein SD, et al.  Migraine prophylaxis with divalproex . Arch Neurol . 1995;;52:281-286.
29 +
Trying S, Barbarash RA, Nahlik JE, et al.  Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia . Ann Intern Med . 1995;;123:89-96.
30 +
Tugwell P, Pincus T, Yocum D, et al.  Combination therapy with cyclosporin and methotrexate in severe rheumatoid arthritis: the Methotrexate-Cyclosporine Combination Study Group . N Engl J Med . 1995;;333:137-141.
31 +
Kirwan JR.  The effect of glucocorticoids on joint destruction in rheumatoid arthritis: the Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group . N Engl J Med . 1995;;333:142-146.
32 +
Malmivaara A, Hakkinen U, Aro T, et al.  The treatment of acute low back pain: bed rest, exercises, or ordinary activity . N Engl J Med . 1995;;332:351-355.
33 +
Bergner M, Bobbit RA, Carter WB, Gilson BS.  The Sickness Impact Profile: development and final revision of a health status measure . Med Care . 1981;; 19:787-805.
34 +
Tarlov AR, Ware JE Jr, Greenfield S, Nelson EC, Perrin E, Zubkoff M.  The Medical Outcomes Study: an application of methods for monitoring the results of medical care . JAMA . 1989;;262:925-930.
35 +
Ware JE, Kosinski M, Bayliss MS, et al.  Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results of the Medical Outcomes Study . Med Care . 1995;;33;AS264-AS279.
36 +
Tandon PK, Stander H, Schwarz RP Jr.  Analysis of quality of life data from a randomized, placebo controlled heart-failure trial . J Clin Epidemiol . 1989;; 42:955-962.
37 +
Smith D, Baker G, Davies G, Dewey M, Chadwick DW.  Outcomes of add-on treatment with lamotrigine in partial epilepsy . Epilepsia . 1993;;34:312-322.
38 +
Chang SW, Fine R, Siegel D, Chesney M, Black D, Hulley SB.  The impact of diuretic therapy on reported sexual function . Arch Intern Med . 1991;; 151:2402-2408.
39 +
Tugwell P, Bombardier C, Buchanan WW, et al.  Methotrexate in rheumatoid arthritis: impact on quality of life assessed by traditional standard-item and individualized patient preference health status questionnaires . Arch Intern Med . 1990;;150:59-62.
40 +
Laupacis A, Wong C, Churchill D.  The use of generic and specific quality-of-life measures in hemodialysis patients treated with erythropoietin . Control Clin Trials . 1991;;12:168S-179S.
41 +
Boyle MH, Torrance GW, Sinclair JC, Horwood SJ.  Economic evaluation of neonatal intensive care of very-low-birth-weight infants . N Engl J Med . 1983;; 308:1330-1337.
42 +
Hornberger JC, Garber AM, Chernew ME.  Is high-flux dialysis cost-effective? Int J Technol Assess Health Care . 1993;;9:85-96.
43 +
Hornberger JC.  The hemodialysis prescription and cost effectiveness . J Am Soc Nephrol . 1993;;4: 1021-1027.
44 +
Naylor CD.  Cost-effectiveness analysis: are the outputs worth the inputs? ACP J Club . 1996;;124: a12-a14.
45 +
Testa MA, Anderson RB, Nackley JF, Hollenberg NK, for the Quality-of-Life Hypertension Study Group.  Quality of life and antihypertensive therapy in men: a comparison of captopril with enalapril . N Engl J Med . 1993;;328:907-913.
46 +
Juniper EF, Guyatt GH, Willan A, Griffith LE.  Determining a minimal important change in a disease-specific quality of life questionnaire . J Clin Epidemiol . 1994;;47:81-87.
47 +
Redelmeier DA, Goldstein RS, Guyatt GH.  Assessing the minimal important difference in symptoms: a comparison of two techniques . J Clin Epidemiol . 1996;;49:1215-1219.
48 +
Jaeschke R, Guyatt G, Keller J, Singer J.  Measurement of health status: ascertaining the meaning of a change in quality-of-life questionnaire score . Control Clin Trials . 1989;;10:407-415.
49 +
Juniper EF, Guyatt GH, Feeny DH, Ferrie PJ, Griffith LE, Townsend M.  Measuring quality of life in children with asthma . Qual Life Res . 1996;;5:35-46.
50 +
Mitchell A, Guyatt G, Singer J, et al.  Quality of life in patients with inflammatory bowel disease . J Clin Gastroentrol . 1988;;10:306-310.

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 +
Feagan BG, Rochon J, Fedorak RN, et al.  Methotrexate for the treatment of Crohn's disease: the North American Crohn's Study Group Investigators . N Engl J Med . 1995;;332:292-297.
2 +
Guyatt GH, Feeny DH, Patrick DL.  Measuring health-related quality of life: basic sciences review . Ann Intern Med . 1993;;70:225-230.
3 +
Gill TM, Feinstein AR.  A critical appraisal of the quality of quality-of-life measurements . JAMA . 1994;;272:619-626.
4 +
Wilson IB, Cleary PD.  Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes . JAMA . 1995;;273:59-65.
5 +
Guyatt GH, Cook DJ.  Health status, quality of life, and the individual . JAMA . 1994;;272:630-631.
6 +
Nocturnal Oxygen Therapy Trial Group.  Continuous or nocturnal oxygen therapy to hypoxemic chronic obstructive lung disease . Ann Intern Med . 1980;;93:391-398.
7 +
Heaton RK, Grant I, McSweeney AJ, Adams KM, Petty TL.  Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease . Arch Intern Med . 1983;;143:1941-1947.
8 +
Mulrow CD, Mulrow JP, Linn WD, Aguilar C, Ramirez G.  Relative efficacy of vasodilator therapy in chronic congestive heart failure: implications of randomized trials . JAMA . 1988;;259:3422-3426.
9 +
Packer M, Carver JR, Rodeheffer RJ, et al.  Effect of oral milrinone on mortality in severe chronic heart failure: the PROMISE Study Research Group . N Engl J Med . 1991;;325:1468-1475.
10 +
Pak CY, Sakhaee K, Piziak V, et al.  Slow-release sodium fluoride in the management of post-menopausal osteoporosis . Ann Intern Med . 1994;; 120:625-632.
11 +
Cook DJ, Guyatt GH, Adachi JD, et al.  Quality of life issues in women with vertebral fractures due to osteoporosis . Arthritis Rheum . 1993;;36:750-756.
12 +
Guyatt GH, Thompson PJ, Berman LB, et al.  How should we measure function in patients with chronic heart and lung disease? J Chronic Dis . 1985;; 38:517-524.
13 +
Mahler DA, Weinberg DH, Wells CK, Feinstein AR.  The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes . Chest . 1984;;85:751-758.
14 +
Rector TS, Kubo SH, Cohn JN.  Patients' self-assessment of their congestive heart failure, II: content, reliability and validity of a new measure—the Minnesota Living With Heart Failure Questionnaire . Heart Failure . 1987;;3:198-209.
15 +
Juniper EF, Guyatt GH, Ferrie PJ, Griffith LE.  Measuring quality of life in asthma . Am Rev Respir Dis . 1993;;147:468-479.
16 +
Wiklund I, Comerford MB, Dimenas E.  The relationship between exercise tolerance and quality of life in angina pectoris . Clin Cardiol . 1991;;14:204-208.
17 +
Osteoporosis Quality of Life Research Group. Measuring quality of life in women with osteoporosis. J Bone Miner Res. In press.
18 +
Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW.  A measure of quality of life for clinical trials in chronic lung disease . Thorax . 1987;; 42:773-778.
19 +
Goldstein RS, Gort EH, Guyatt GH, Stubbing D, Avendano MA.  Prospective randomized controlled trial of respiratory rehabilitation . Lancet . 1994;;344: 1394-1397.
20 +
Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG.  A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia: the Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate . N Engl J Med . 1995;;332:75-79.
21 +
Guyatt GH, Mitchell A, Irvine EJ, et al.  A new measure of health status for clinical trials in inflammatory bowel disease . Gastroenterology . 1989;;96:804-810.
22 +
Kirshner B, Guyatt GH.  A methodologic framework for assessing health indices . J Chronic Dis . 1985;;38:27-36.
23 +
Guyatt GH, Kirshner B, Jaeschke R.  Measuring health status: what are the necessary measurement properties? J Clin Epidemiol . 1992;;45:1341-1345.
24 +
De Weerdt I, Visser AP, Kok GI, de Weerdt 0, Van der Veen EA.  Randomized controlled multicentre evaluation of an education programme for insulin-treated diabetic patients: effects on metabolic control, quality of life, and costs of therapy . Diabet Med . 1991;;8:338-345.
25 +
Irvine EJ, Feagan B, Rochon J, et al.  Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease . Gastroenterology . 1994;;106:287-296.
26 +
Greenberg GR, Feagan BG, Martin F, et al.  Oral budesonide for active Crohn's disease: Canadian Inflammatory Bowel Disease Study Group . N Engl J Med . 1994;;331:836-841.
27 +
Salonen R, Ashford E, Dahlof C, et al.  Intranasal sumatriptan for the acute treatment of migraine . J Neurol . 1994;;241:463-469.
28 +
Mathew NT, Saper JR, Silberstein SD, et al.  Migraine prophylaxis with divalproex . Arch Neurol . 1995;;52:281-286.
29 +
Trying S, Barbarash RA, Nahlik JE, et al.  Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia . Ann Intern Med . 1995;;123:89-96.
30 +
Tugwell P, Pincus T, Yocum D, et al.  Combination therapy with cyclosporin and methotrexate in severe rheumatoid arthritis: the Methotrexate-Cyclosporine Combination Study Group . N Engl J Med . 1995;;333:137-141.
31 +
Kirwan JR.  The effect of glucocorticoids on joint destruction in rheumatoid arthritis: the Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group . N Engl J Med . 1995;;333:142-146.
32 +
Malmivaara A, Hakkinen U, Aro T, et al.  The treatment of acute low back pain: bed rest, exercises, or ordinary activity . N Engl J Med . 1995;;332:351-355.
33 +
Bergner M, Bobbit RA, Carter WB, Gilson BS.  The Sickness Impact Profile: development and final revision of a health status measure . Med Care . 1981;; 19:787-805.
34 +
Tarlov AR, Ware JE Jr, Greenfield S, Nelson EC, Perrin E, Zubkoff M.  The Medical Outcomes Study: an application of methods for monitoring the results of medical care . JAMA . 1989;;262:925-930.
35 +
Ware JE, Kosinski M, Bayliss MS, et al.  Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results of the Medical Outcomes Study . Med Care . 1995;;33;AS264-AS279.
36 +
Tandon PK, Stander H, Schwarz RP Jr.  Analysis of quality of life data from a randomized, placebo controlled heart-failure trial . J Clin Epidemiol . 1989;; 42:955-962.
37 +
Smith D, Baker G, Davies G, Dewey M, Chadwick DW.  Outcomes of add-on treatment with lamotrigine in partial epilepsy . Epilepsia . 1993;;34:312-322.
38 +
Chang SW, Fine R, Siegel D, Chesney M, Black D, Hulley SB.  The impact of diuretic therapy on reported sexual function . Arch Intern Med . 1991;; 151:2402-2408.
39 +
Tugwell P, Bombardier C, Buchanan WW, et al.  Methotrexate in rheumatoid arthritis: impact on quality of life assessed by traditional standard-item and individualized patient preference health status questionnaires . Arch Intern Med . 1990;;150:59-62.
40 +
Laupacis A, Wong C, Churchill D.  The use of generic and specific quality-of-life measures in hemodialysis patients treated with erythropoietin . Control Clin Trials . 1991;;12:168S-179S.
41 +
Boyle MH, Torrance GW, Sinclair JC, Horwood SJ.  Economic evaluation of neonatal intensive care of very-low-birth-weight infants . N Engl J Med . 1983;; 308:1330-1337.
42 +
Hornberger JC, Garber AM, Chernew ME.  Is high-flux dialysis cost-effective? Int J Technol Assess Health Care . 1993;;9:85-96.
43 +
Hornberger JC.  The hemodialysis prescription and cost effectiveness . J Am Soc Nephrol . 1993;;4: 1021-1027.
44 +
Naylor CD.  Cost-effectiveness analysis: are the outputs worth the inputs? ACP J Club . 1996;;124: a12-a14.
45 +
Testa MA, Anderson RB, Nackley JF, Hollenberg NK, for the Quality-of-Life Hypertension Study Group.  Quality of life and antihypertensive therapy in men: a comparison of captopril with enalapril . N Engl J Med . 1993;;328:907-913.
46 +
Juniper EF, Guyatt GH, Willan A, Griffith LE.  Determining a minimal important change in a disease-specific quality of life questionnaire . J Clin Epidemiol . 1994;;47:81-87.
47 +
Redelmeier DA, Goldstein RS, Guyatt GH.  Assessing the minimal important difference in symptoms: a comparison of two techniques . J Clin Epidemiol . 1996;;49:1215-1219.
48 +
Jaeschke R, Guyatt G, Keller J, Singer J.  Measurement of health status: ascertaining the meaning of a change in quality-of-life questionnaire score . Control Clin Trials . 1989;;10:407-415.
49 +
Juniper EF, Guyatt GH, Feeny DH, Ferrie PJ, Griffith LE, Townsend M.  Measuring quality of life in children with asthma . Qual Life Res . 1996;;5:35-46.
50 +
Mitchell A, Guyatt G, Singer J, et al.  Quality of life in patients with inflammatory bowel disease . J Clin Gastroentrol . 1988;;10:306-310.

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