Assessing quality of life in research and clinical practice

There is a growing recognition in oncology of the importance of maintaining or improving patients' quality of life (QOL) throughout the disease course. With this goal in mind, many clinical trials in oncology now seek to evaluate QOL endpoints. In using QOL measures as research tools, investigators need to consider which instrument is best suited to addressing the issues under study, how often and when to administer the instrument, and how to deal with data that may be missing due to toxicity, morbidity, or mortality. Findings from QOL research can inform clinical care by providing information about the likely impact of disease and its treatment on functioning and wellbeing, identifying common problems, and developing effective interventions to deal with these problems. The routine assessment of QOL may also have clinical uses at the individual patient level. These uses include fostering patient-provider communication, identifying frequently overlooked problems, prioritizing problems, and evaluating the impact of palliative and rehabilitative efforts. Although several barriers exist to routine assessment of quality of life in clinical practice, several strategies can be used to successfully overcome these barriers.