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The efficacy of a therapy has been primarily based on
objective criteria such as mortality and morbidity. In addition to these objective
criteria, interest has increased in recent years in the measurement of quality of life in
relation to health care. Quality of life is now the new "catch phrase" in
medicine. Like happiness, it is one of those terms that we all understand but for which
adequate definitions do not exist. It is generally agreed that quality of life should be
measured as an integral component of most trials, particularly where treatments are given
with an intention to palliate or reduce symptoms1. The
term quality of life suggests an abstract and philosophical approach, but in reality most
approaches used in medical contexts do not attempt to include more general notions such as
life satisfaction or standard of living, and rather tend to concentrate on aspects of
personal experience that might be related to health and health care2. The incorporation of quality of life measurements in
clinical studies is fortunately receiving a higher priority and often provides information
that would be unobtainable by other means. It is important to distinguish the different
applications of quality of life measure because instruments that have proven useful when
applied in one context may be less appropriate elsewhere. A good research tool may be
impractical for clinical uses. Generally, more attention has been given to the use of
quality of life instruments in clinical trials than to an examination of their value in
routine clinical care, medical audit, or resource allocation1-4.
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