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February 11, 1998

Defining and Measuring Quality of Life in Medicine—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(6):429-431. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-6-jac81007

In Reply.— In response to both the critical and sympathetic letter authors, our main concern is that there seems to be some discrepancy between the prevalent discourse of what quality-of-life and HRQL instruments are supposed to measure and what they actually do measure. In our technical jargon, we would say that there is a content validity issue (ie, most so-called quality-of-life instruments do not measure quality of life but health status instead). We think that such a situation should be dealt with seriously, since stating that the outcome of a given medical intervention is an improvement in the quality of life of the recipients may raise undue expectations among the patients, the medical community, the public, or the regulatory authorities. Therefore, we believe our responsibility is to address this problem publicly and call for a much needed debate.

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