Papers reporting studies of health outcomes, particularly patients' perceptions, are becoming more common. Understanding the characteristics of tools used to measure these health outcomes is important for interpreting these studies accurately and applying them to clinical care.
Objective:
The purpose of this article is to describe important features of the measurement of patient-perceived health outcomes, and to illustrate how a consideration of these features can help in applying study results to individual patients.
Conclusion:
Understanding the principles of measurement is particularly important for interpreting studies of dermatological care, in which patients' perceptions are a crucial outcome.
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References
1.
McDermottW. Absence of indicators of the influence of its physicians on a society's health. Impact of physician care on society. Am J Med1981; 70:833–843.
2.
EllwoodPM. Outcomes management. A technology of patient experience. N Engl J Med1988; 318:1549–1556.
3.
ChrenMM. Quality of care in dermatology: The state of (measuring) the art. Arch Dermatol1997; 133:1349–13451.
4.
ChrenMMLasekRJ. “Skindex,” a dermatological outcomes measure of the effects of skin disease on patients' quality of life. In: RajagopalanRSherertzEFAndersonRT, eds. Care management of skin diseases: Life quality and economic impact. New York: Marcel Dekker, 1997:153–169.
5.
FredrikssonTPetterssonU. Severe psoriasis—oral therapy with a new retinoid. Dermatologica1978; 157:238–244.
6.
ChrenMM. Dermatologic health services research. Dermatol Clin1995; 13:689–695.
7.
MarksRBartonSPShuttleworthDFinlayAY. Assessment of disease progress in psoriasis. Arch Dermatol1989; 125:235–240.
8.
TestaMASimonsonDC. Assessment of quality-of-life outcomes. N Engl J Med1996; 334:835–840.
9.
SalekMSFinlayAYLuscombeDK. Cyclosporin greatly improves the quality of life of adults with severe atopic dermatitis. A randomized, double-blind, placebo-controlled trial. Br J Dermatol1993; 129:422–430.
10.
SalekMSLuscombeDKWalkerSR. Quality of life assessment in patients with angina using the sickness impact profile (SIP). Br J Clin Pharmacol1988; 25:99–100.
11.
FinlayAYKhanGKLuscombeDKSalekMS. Validation of UK Sickness Impact Profile and Psoriasis Disability Index in psoriasis. Br J Dermatol1990; 123:751–756.
12.
ChrenMMLasekRJQuinnLM. Skindex, a quality-of-life measure for patients with skin disease: Reliability, validity, and responsiveness. J Invest Dermatol1996; 107:707–713.
13.
ChrenMMLasekRJQuinnLMCovinskyKE. Convergent and discriminant validity of a generic and a disease-specific instrument to measure quality of life in patients with skin disease. J Invest Dermatol1997; 108:103–107.
14.
PatrickDLDeyoRA. Generic and disease-specific measures in assessing health status and quality of life. Med Care1989; 27: S217–S232.
15.
ChrenMMLasekRJFlockeSAZyzanskiSJ. Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases. Arch Dermatol1997; 133:1433–1440.
16.
WilsonIBClearyPD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA1995; 273:59–65.
17.
GuyattGHNaylorCD, Juniper E, et al, for the Evidence-Based Medicine Working Group. Users' guides to the medical literature. How to use articles about health-related quality of life. JAMA1997; 277:1232–1237.
18.
ChenSShaheenAGarberA. Cost-effectiveness and cost-benefit analysis of using methotrexate vs. Goeckerman therapy for psoriasis. A pilot study. Arch Dermatol1998; 134:1602–1608.
19.
ZugKALittenbergBBaughmanRD. Assessing the preferences of patients with psoriasis. A quantitative, utility approach. Arch Dermatol1995; 131:561–568.
20.
BeatonDEHogg-JohnsonSBombardierC. Evaluating changes in health status: Reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders. J Clin Epidemiol1997; 50:79–93.
21.
SullivanMAhlménMBjelleA. Health status assessment in rheumatoid arthritis. I. Further work on the validity of the sickness impact profile. J Rheumatol1990; 17:439–447.
22.
FinlayAYKellySE. Psoriasis—an index of disability. Clin Exp Dermatol1987; 12:8–11.
