Who should measure quality of life, the doctor or the patient?

Abstract

Summary The extent to which a doctor or health professional can make a valid assessment of a patient's quality of life, anxiety and depression was investigated in a series of cancer patients. Doctors and patients filled out the same forms, viz. the Karnofsky, Spitzer, Linear Analogue Self Assessment Scales and a series of simple scales designed for this study, at the same time. Correlations between the two sets of scores were poor, suggesting that the doctors could not accurately determine what the patients felt. A further study examining the reproducibility of these scales demonstrated considerable variability in results between different doctors. It is concluded that if a reliable and consistent method of measuring quality of life in cancer patients is required, it must come from the patients themselves and not from their doctors and nurses.

Small cell lung cancer

“…A tendency to complete forms in batches rather than daily is a common problem (Peck & Dean, 1983). The concept of selfassessment is commendable and concurs with Slevin's conclusion that a patient is the best judge of his quality of life (Slevin et al, 1988). There was then no conclusive benefit for treatment beyond the initial six courses, toxicity increased and the quality of life was adversely affected by prolonging treatment.…”

Usefulness of chemotherapy beyond the second line for metastatic breast cancer: a therapeutic challenge

“…In clinical practice, when a patient is considered for CT3, the physician is confronted with two major decisions. First , should chemotherapy be proposed, considering the potential risk of to xicity and the psychological impact of abstention [53][54] ? And if the decision is made to treat, how aggressive should the treatment be?…”

Comparison between reduction in 24‐hour pad weight, International Consultation on Incontinence‐Short Form (ICIQ‐SF) score, International Prostate Symptom Score (IPSS), and Post‐Operative Patient Global Impression of Improvement (PGI‐I) score in patient evaluation after male perineal sling

“…Clearly, it is preferable to evaluate patients by an objective test or by patient self-assessment to eliminate physician bias [Slevin et al, 1988;Aaronson, 1989]. Many validated self-assessment instruments have been utilized in the evaluation of incontinence and anti-incontinence treatments .…”

“…Selfassessment instruments and objective tests have been recommended to eliminate the confounding factor of physician bias [Slevin et al, 1988;Aaronson, 1989]. As a result, many validated self-assessment instruments have been recommended Donovan et al, 2002].…”