Summary
Background: Two major issues in quality of life (QOL) research include the patients’ opinion as a contributing factor in QOL-assessments, and the lack of sensitivity of QOL-assessments.
Objectives: To review results from recent research by the Dutch Mononitrate Quality Of Life (DUMQOL) Study Group relevant to these issues.
Results: Using a test-battery including Stewart’s Short Form (SF)-36 Questionnaire and the DUMQOL-50 questionnaire, the DUMQOL Study Group tested the hypothesis that the patients’ opinion might be an independent determinant of QOL and performed for that purpose a stepwise multiple regression analysis of data from 82 outpatient clinic patients with stable angina pectoris. Psychological distress was the most important contributor to QOL (beta 0.43, P<0.0001). Also, the patients’ opinion significantly contributed to QOL (beta 0.22, P= 0.032). Physical health status according to the patients’ judgment only made a borderline contribution (beta 0.19, P=0.71), while the physicians’ judgment was not associated with QOL at all (beta 0.11, P=0.87). Using an Odds ratio approach of QOL scores in 1350 outpatient clinic patients with stable angina pectoris the DUMQOL Study Group assessed the question that relative scores might provide increased precision to estimate the effects of patient characteristics on QOL data. Increased QOL difficulties were observed in New York Heart Association Angina Class (NYHA) III-IV patients, in patients with comorbidity, as well as in females and elderly patients. Odds ratios can be used in these categories to predict the benefit from treatments.
Conclusions: Recent QOL-research of the DUMQOL Study Group allows for conclusions relevant to clinical practice. QOL should be defined in a subjective rather than objective way. The patients’ opinion is an important independent contributor to QOL. The comparison of absolute QOL-scores lacks sensitivity to truly estimate QOL. The odds ratio approach of QOL scores provides increased precision to estimate QOL.
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Cleophas, T.J., Zwinderman, A.H., Cleophas, T.F. (2002). Quality-of-Life Assessments in Clinical Trials. In: Statistics Applied to Clinical Trials. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0337-7_15
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DOI: https://doi.org/10.1007/978-94-010-0337-7_15
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