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Letters
April 12, 2000

Assessing Patients' Views of Clinical Changes—Reply

Author Affiliations
 

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(14):1824-1825. doi:10.1001/jama.283.14.1821

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.

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