[Measurement of quality of life in rheumatic practice]

Hard, objective data to evaluate outcome in patients with rheumatology diseases is not only difficult to obtain, but often poorly correlated with the degree of the functional incapacity caused by these non-fatal but disabilitating diseases. Soft, subjective data does not meet the traditional criteria for scientific research. However, due to important advances in the field of psychometry and its medical applications, we now have adequate instruments to evaluate quality of life, the major outcome parameter in patients with chronic rheumatic diseases. The Arthritis Impact Measurement Scales is the most widely used and is particularly adapted to patients with rheumatoid arthritis. Other scales include the Health Assessment Questionnaire, the Nottingham Health Profile, and the Sickness Impact Profile. Most of the studies conducted in the field of rheumatology concern patients with rheumatoid arthritis or osteoarthritis of the lower limbs. Quality of life measures can however be applied to most all the different clinical situations including low back pain, ankylosing spondylitis and systemic diseases. Quality of life measures will play an important role in treatment evaluation procedures. They correspond to real progress in responding to the legitimate demand of patient with chronic diseases for effective validated health care.