Quality-of-life assessments and chronic liver disease

Clinicians, researchers, and policy makers are increasingly recognizing the importance of measuring quality of life (QOL) to complement clinical, physiological and biochemical outcomes and to integrate the traditional "biomedical model" of health with the "social science or QOL model." This view is of particular importance to patients with chronic liver diseases because of the intense resource utilization and the profound impact of liver disease on patients' well-being. Although many extensively validated generic QOL instruments are available, a disease-specific instrument for chronic liver disease is not available. Generic indices allow investigators the opportunity to capture the global impact of disease on patients' well-being and to compare different programs with disparate endpoints. A disease-specific instrument may be more responsive and may capture small but clinically important changes that occur as a result of therapy or natural progression of disease. This article reviews all important issues of QOL and their relevance to patients with chronic liver diseases.