FOTO Rehab Outcomes

The Downside of Generic Quality of Life Assessments

Written by Selena Horner | Jul 24, 2017 10:30:00 AM

I am always intrigued reading research that focuses on quality-adjusted life year and the comparative effectiveness studies.  I think it is great to  know when comparing interventions if one has a higher mortality rate or higher costs due to complications. 

The problem I have with most of these studies is the tool used to determine "quality." As the research below indicates, EQ-5D-5L is one of the patient reported outcome measures often used. Have you seen the EQ-5D-5L? The static measurement looks at 6 things.  I don't know about you, but I tend to believe my quality of life is more than just being able to walk, wipe my butt, do my usual activities, my level of pain and my level of anxiety and depression. The generic tools are just that - generic. It feels more like a screening tool.  The scoring system really isn't a score.  It's a description. A 13311 means that the person can walk around without any problem, has moderate problems with washing oneself and dressing, has moderate problems with usual activities, has no pain and has no anxiety or depression.  I don't understand how a description can be changed to an index value.  

The problem I've always had with a generic tool like the EQ-5D-5L is the generic aspect of it. Disease-specific or condition specific or region specific tools provide a far better picture of just how well a patient is functioning. There will be less ceiling and floor effects compared to the generic tool. The responsiveness  of specific tools is much greater.  

Anyways, it's good to see researchers contemplating generic versus specific patient reported outcome measures.

Below you will find a quick view of the abstract.

Quality of life assessment in musculo-skeletal health.

 

Abstract

Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.

Aging Clin Exp Res. 2017 Jun 29. doi: 10.1007/s40520-017-0794-8. [Epub ahead of print]