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—We thank the writers of these letters for contributing to a long overdue discussion about how to evaluate a patient's quality of life. We especially applaud Dr Hürny and colleagues for using global ratings to measure important clinical phenomena. These ratings, which can capture the disparate values and preferences of individual patients, offer investigators the most overtly sensible approach to measure quality of life. We acknowledge that an instrument may not be clinically useful, despite high face validity, if it cannot measure the desired phenomenon consistently and accurately. We remind Drs Perneger and Hudelson, however, that face validity is often the most important attribute of an instrument that is intended to reflect the complex observations of clinical experience. If aimed at the wrong thing or constructed in an unsatisfactory way, the instrument will lack clinical sensibility and will be inadequate no matter how many statistical accolades are acquired
Gill TM, Feinstein AR. The Quality of Quality-of-Life Measurements-Reply. JAMA. 1995;273(11):845. doi:10.1001/jama.1995.03520350025018