Outcome assessment: functional status measures as therapeutic endpoints for heart failure

The role of measures of patients' functional status during chronic heart failure is to bridge the outcome information gap between physiologic assessments and the goal of medical care, which is to prolong the patient's life with minimal disability due to the syndrome and subsequent health care. The methods of rigorously developing and applying patient questionnaires as outcome measures will be unfamiliar to many health care providers. Many health care providers trained with different perspectives probably have an incredulous view of patient evaluations. What have we accomplished, though, if patients cannot perceive a net benefit from our services? In the final analysis, the patients' outcome assessments, collected in a systematic and unbiased manner, rather than the proxy measures used by health care providers, are the bottom line.