Definition, Measures, Applications, & Facts

The measure rests on the analysis of variance and can be used with ordinal as well as interval data. An intraclass correlation coefficient of, for example, 0.80 or higher indicates that the measure is highly reliable. If the measure is categorical, Cohen’s kappa (Fleiss 1981) is most frequently used to assess the level of agreement beyond that expected by chance. For rankings of ordinal measures, Spearman’s rho and Kendall’s tau may be used as measures of agreement in addition to kappa. Pearson’s product moment correlation is commonly used for comparing quantitative scores of raters. The items can be divided and placed on alternate forms of the measure; the equivalence of the alternate forms can be tested by comparing the alphas.

The second step was to classify the same individuals by the symptoms and health problems that they have on a given day. Four hundred case descriptions were written to encompass the combinations of functional levels and symptoms or problems. The general approach for assessing utility values is based on modern utility theory, advanced by von Neumann and Morgenstern (1953). The theory describes a method for decisionmaking under conditions of uncertainty based on a set of axioms of rational behavior. Holloway (1979) has summarized the wide uses of this model for decisionmaking.

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1. This section collects any data citations, data availability statements, or supplementary materials included in this article.
2. Although researchers and policymakers tend to make much of the distinction between objective and subjective measures, both are probably necessary when assessing quality of life, and both require investigations into their reliability and validity.
3. Women in the cytotoxic group had higher symptom-related scores and higher quality-of-life scores than women in the endocrine group.
4. A first step in assessing the validity of a measure is to determine if the content of the items represents the domain or dimension of interest.
5. We also refer readers to the Clearinghouse on Health Indexes of the National Center for Health Statistics of the U.S.

Karnofsky and Burchemal (1949) were among the first to develop a measure to assess the ability of cancer patients to perform daily activities. Their measure has been studied extensively and is widely used, although it has been criticized both conceptually and for its measurement properties. The consensus seems to be that it continues to be a useful tool for physicians to use in rating the impact of cancer and cancer treatment on patients’ ability to lead normal lives.

Subjective versus outsider perspectives

Despite the importance of QOL in health and medicine, there is a continuing conceptual and methodological debate about the meaning of QOL and about what should be measured. Quality of life (QOL) has become established as a significant concept and target for research and practice in the fields of health and medicine 1. Traditionally, biomedical and not QOL outcomes have been the principal endpoints in medical and health research.

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Group scores of patients with different levels of clinical severity differed significantly, demonstrating that the instrument could distinguish between groups of patients. We found no published reports that compare the utility values derived by the standard gamble, time trade-off, and rating scale methods outlined by Torrance with the QWB utility values developed by the San Diego group. The scores from repeated testing over the course of treatment for advanced cancer have been reported for individual items, but we found no reports of the formal psychometric properties in the measure. A minority of eligible subjects participated in the repeated use of the form, but the loss to follow-up is not explained. The use of the LASA needs to be standardized so that measurement properties of the resulting scales can be formally tested. If the variables being considered are sufficiently objective to be evaluated by persons other than the patients, it is possible to compare raters’ scores.

The purpose of the repeated measures is to assess patients’ short-term responses during the course of therapy. The findings of this systematic snapshot review show that QOL research is truly international, involves a variety of target groups, and uses different research designs and many types of QOL measures. Moreover, few of the included studies provided a definition of the concept of QOL, and most articles had a low-quality score according to the criteria of Gill and Feinstein 5, quality of life definition 8.

The World Health Organization explains QoL as a subjective evaluation of one’s perception of their reality relative to their goals as observed through the lens of their culture and value system. The Quality of Life Research Unit at the University of Toronto defines QoL as how much a person can enjoy the valued possibilities of their lives. It is essential to recognize the difference between QoL and other somewhat similar concepts which might get easily confused in the literature, such as the standard of living and health-related quality of life.