Computer-assisted quality of life assessment for clinical trials

A patient's quality of life is difficult to assess. Most methods designed to evaluate quality of life for clinical trials are time consuming, subject to varied interpretation among patients and assessors, and apply scales with only a limited relationship to utility theory. We have developed a HyperCard program, incorporating animated graphics, to (1) improve the speed of collection and collation of data, (2) improve understanding between patients and assessors, and (3) incorporate utility theory-based assessments. We assessed the quality of life of 25 patients with end-stage renal disease receiving hemodialysis using a traditional paper-based presentation and, eight months later, repeated the assessment with a computer-assisted presentation. Each presentation incorporated five techniques for evaluating quality of life: the Campbell Index of Well-being, the Kaplan-Bush Index of Well-being, categorical scaling, standard gamble, and time tradeoff. The computer program improved the speed of collation of data for statistical analysis, provided a consistent interface among patients for utility assessments, and showed stable reporting of patient's well-being. These findings suggest that further development of computer-assisted assessments of patients' quality of life for clinical trials is warranted.