To the Editor.
—The article by Drs Gill and Feinstein1 and the Commentary by Drs Guyatt and Cook2 concerning the relevance of qualitative assessments as appropriate outcome measures are timely. In a metaphorical sense it is like a psychiatrist trying to determine whether a patient is clinically depressed by asking how he or she feels and then deciding whether the answer reflects the patient's affect or mood or, possibly, both.Second, medicine as an art may derive some useful direction in planning the overall medical management of a patient from well-defined quality-of-life measures, but for medicine as a science, such measures are not rigorous enough. Qualitative measures, or functional measures based on subjective situational evaluations, are too variable to be used in comparative efficacy studies. This is not to discount the value of including a patient's outlook on life when determining which treatment is most suitable, given treatment
Jung BC. The Quality of Quality-of-Life Measurements. JAMA. 1995;273(11):844. doi:10.1001/jama.1995.03520350025015