To the Editor.
—The GIVIO Investigators1 report that intensive follow-up clinical testing has no significant effects on quality of life and mean postoperative survival in patients with breast cancer. The criteria contained in quality-of-life indexes has been shown to be a consistent and valid predictor of survival time in patients with terminal and nonterminal illnesses.2,3The use of the measure of quality of life in this population to determine the effects of clinical procedures seems inappropriate. These patient indexes are often used as a means of determining the effects of intervention or treatment in individuals participating in experimental pharmacological protocols. This is where the strength of these tests as predictor variables may lie.In multidose clinical drug trials, a quality-of-life questionnaire is invaluable. Affective states, relationship factors, overall health, and functioning are important factors that aid in determining dose-limiting toxicities and maximum therapeutic benefits. Pretreatment vs posttreatment quality-of-life
Klaff RA. Follow-up of Patients With Breast Cancer. JAMA. 1994;272(21):1658. doi:10.1001/jama.1994.03520210041023