Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
To the Editor: Dr Fischer and colleagues1 recently proposed a means of capturing the patient's
view of change as a clinical outcome measure. Like rheumatologists, geriatricians
struggle to find measurement instruments that are sensitive to the clinically
important change that can occur with treatment for chronic disease. We agree
with the authors that outcome measures such as death are inadequate in patient
populations in whom the issue is quality, and not just quantity, of life.
The heterogeneity of elderly patients' problems also compromises both the
meaningfulness and responsiveness of many standardized scales. We strongly
support the authors' view that the patient's (and family's) opinion of what
is a relevant and meaningful change must be captured if we are to evaluate
properly what we do.
Gordon J, Rockwood K, Powell C. Assessing Patients' Views of Clinical Changes—Reply. JAMA. 2000;283(14):1824-1825. doi:10.1001/jama.283.14.1821