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Handbook of Disease Burdens and Quality of Life Measures pp 179–194Cite as

The Uniscale Assessment of Quality of Life: Applications to Oncology

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Abstract:

The measurement of quality of life (QOL) is an important challenge in clinical research, not only because QOL is one of the two main endpoints of effectiveness of treatments, the other being overall survival, but also for taking clinical decisions shared with the patient. Today, QOL is generally assessed using psychometric questionnaires; nevertheless, these latter suffer from several shortcomings that often lead to unreliable results.

About 14 years ago, the Italian Group for the Evaluation of Outcomes in Oncology (IGEO) planned a research program articulated in two phases. In the first phase, domains of QOL and problems connected with it were defined performing a content analysis of the interviews of 248 Italian cancer patients, based on four areas related to the foundations of quality of life. The domains/problems referred by the patients were submitted to a large population of more than 6,000 Italian cancer patients so as to assign a frequency to the relevance of each domain and to the presence/absence of each problem. In this study, a uniscale evaluation of QOL, using a Visual Analogue Scale (VAS), was also obtained. The rating of each patient was classified in “bad QOL” and “good QOL,” if the chosen point fell in the 0–30 or 70–100 interval, respectively; the other scores (30–70 interval) were not considered.

The relationship between the uniscale assessment of QOL and the presence of each problem was investigated. The impact of each problem, adjusted for the presence of the others, and for the patient’s characteristics, was detected by a unifactorial analysis using logistic additive models, where “good” and “bad” QOL were in turn considered as dependent variables. Thirteen of 19 problems were significant, and this confirms the external validity of the uniscale assessment of QOL.

A VAS can be considered a reference point in multidimensional QOL scales and should still be regarded as a useful and synthetic tool to investigate phenomena related to the patient’s QOL. In this perspective, more research on the psychometric properties of this instrument, in the context of the assessment of QOL, is still needed.

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Abbreviations

CRF:

Case Record Form

HRQL:

Health-Related Quality of Life

IGEO:

Italian Group for the Evaluation of Outcomes in Oncology

KPS:

Karnofsky Performance Status

LP:

Linear Predictor

NED:

No Evidence of Disease

NHS:

National Health System

OR:

Odds Ratio

QOL:

Quality of Life

RR:

Relative Risk

SD:

Standard Deviation

VAS:

Visual Analogue Scale

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Acknowledgments

Tables 10-2 , 10-3 , 10-6 were reproduced with kind permission of the Editor of Tumori.

We thank Mrs Katherine Brandt for her helpful assistance in reviewing the text.

Author information

Authors and Affiliations

  1. Professor of Medical Statistics, Biostatistician Freelance, Via Pillino, AP, Italy

    E. Ballatori

  2. Medical Oncology Division, Regional Hospital, Ospedale ‘S. Maria della Misericordia’, S, Andrea delle Fratte, Perugia, Italy

    F. Roila

  3. Department of Internal Medicine and Public Health, University of L’Aquila, P.le S. Tommasi, Italy

    S. Tiberti

  4. Department of Internal Medicine and Public Health, University of L’Aquila, P.le S. Tommasi, Italy

    F. di Orio

Authors
  1. E. Ballatori
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  2. F. Roila
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  3. B. Ruggeri
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  4. A. A. Bruno
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  5. S. Tiberti
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  6. F. di Orio
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Editor information

Editors and Affiliations

  1. Dept. Nutrition and Dietetics Nutritional Sciences Research Division School of Biomedical & Health Sciences, King's College London, Franklin‐Wilkins Building 150 Stamford Street, SE1 9NH, London, UK

    Victor R. Preedy (Prof.) (Prof.)

  2. Mel and Enid Zuckerman College of Public Health, University of Arizona, Health Science Center 1295 N. Martin, P.O. Box 245155, 85724-5155, Tucson, AZ

    Ronald R. Watson (Prof.) (Prof.)

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Ballatori, E., Roila, F., Ruggeri, B., Bruno, A.A., Tiberti, S., di Orio, F. (2010). The Uniscale Assessment of Quality of Life: Applications to Oncology. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_10

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  • DOI: https://doi.org/10.1007/978-0-387-78665-0_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-78664-3

  • Online ISBN: 978-0-387-78665-0

  • eBook Packages: MedicineReference Module Medicine

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