, Volume 1, Issue 3, pp 182–190 | Cite as

Selection of Items and Avoidance of Bias in Quality of Life Scales

  • Michael E. Hyland
Review Article


The total score of a quality of life (QOL) questionnaire reflects the items that make up the questionnaire. Although different questionnaires have strikingly similar items, the balance between types of items can affect research outcomes. Four general quality of life (QOL) scales and one specific scale may be compared to show how the balance of items can bias the results to: (a) increase or decrease the chance of obtaining a significant result in a clinical trial; (b) make one treatment appear better or worse compared with that of a competitor; (c) make the QOL of one disease category appear better or worse than that of another disease category. Healthcare decision-making should be based on relatively unaggregated measures of health.


Asthma General Scale Nottingham Health Profile Specific Scale Asthma Questionnaire 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anastasi A. Psychological testing, 6th ed., Macmillan, New York, 1988Google Scholar
  2. Bowling A. Measuring health: a review of quality of life measurement scales. Open University Press, Milton Keynes, UK, 1991Google Scholar
  3. Hunt SM, McEwen J, McKenna S. Measuring health status. Croom Helm, London, 1986Google Scholar
  4. Bergner M, Bobbitt RA, Carter WB, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Medical Care 19: 787–805, 1981PubMedCrossRefGoogle Scholar
  5. Freund DA, Dittus RS. Principles of pharmacoeconomic analysis of drug therapy. PharmacoEconomics 1: 20–29, 1992PubMedCrossRefGoogle Scholar
  6. Goldberg D, Williams P. A user’s guide to the General Health Questionnaire. NFER-Nelson, Windsor, UK, 1988Google Scholar
  7. Hyland ME, Finnis S, Irvine SH. A scale for assessing quality of life in adult asthma sufferers. Journal of Psychosomatic Research 35: 99–110, 1991PubMedCrossRefGoogle Scholar
  8. Jaeschke R, Guyatt GH, Cook D. Quality of life instruments in the evaluation of new drugs. PharmacoEconomics 1: 84–94, 1992PubMedCrossRefGoogle Scholar
  9. Kaplan RM, Bush JW. Health-related quality of life measurement for evaluation research and policy analysis. Health Psychology 1: 61–80, 1982CrossRefGoogle Scholar
  10. Kaplan RM, Anderson JP. The general health policy model: an integrative approach. In Spilker B (Ed.) Quality of life assessment in clinical trials, pp. 131–149, ((publisher to come)), 1990Google Scholar
  11. Spilker B. Standardisation of quality of life trials: an industry perspective. PharmacoEconomics 1: 73–75, 1992PubMedCrossRefGoogle Scholar
  12. Stewart AL, Hays RD, Ware JE. The MOS short-short form general health survey. Medical Care 26: 724–735, 1988PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1992

Authors and Affiliations

  • Michael E. Hyland
    • 1
  1. 1.Department of PsychologyPolytechnic South West PlymouthPlymouth, DevonEngland

Personalised recommendations