S2) Health-related Quality of Life

• Target resources where they are most needed • Monitor patients’ progress • Indication of the need for healthcare • Evaluate the quality of health services

• Mortality • Morbidity • Patient-based outcomes

Patient-based outcomes are an attempt to assess well-being from the patient’s point of view E.g. health-related quality of life, health status, functional abilities

Used in conditions where the aim is managing rather than curing

• Patient-reported outcome measures (PROMs) are measures of health that come directly from patients • They work by comparing scores before and after treatment or over longer-periods

• Hip replacements • Knee replacements • Groin hernia • Varicose vein

• Time and cost of collection, analysis, and presentation of data • Achieving high rates of patient participation • Providing appropriate output to different audiences • Avoiding misuse of PROMs

Quality of life in clinical medicine represents the functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient

• Physical function • Symptoms • Psychological well-being • Social well-being • Satisfaction with care

• Can be used with any population • Generally cover perceptions of overall health (social, emotional and physical functioning, pain and self-care)

• Used for broad range of health problems • Used if no disease-specific instrument • Enable comparisons across treatment groups

• Less detailed • Loss of relevance • Less acceptable to patients

• The Short-Form 36-item questionnaire (SF-36) • The EuroQol EQ-5D

Specific instruments evaluates a series of health dimensions specific to a disease, site or dimension

• Disease specific – e.g. Asthma Quality of Life Questionnaire - Site specific – e.g. Oxford Hip Score - Dimension specific – e.g. Beck Depression Inventory

• Very relevant content • Sensitive to change • Acceptable to patient

• Comparison is limited • May not detect unexpected effects • Cannot be used on any population