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February 11, 1998

Defining and Measuring Quality of Life in Medicine

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

To the Editor.—Drs Leplége and Hunt1 introduce and discuss some relevant issues related to the use and actual value of the term quality of life in medical research. The hub of their interesting paper is that there is confusion in the field, mainly resulting from the lack of valid and robust conceptualization of the very concept that it is intended to measure. In other words, the central point is that when using HRQL instruments, what we, at best, actually measure is the "objective" health status filtered by the patient's "subjective" perception of health, forcing the patient to deal with a model of health and illness that is the product of the medical point of view. Leplége and Hunt challenge the current approach, and, although acknowledging the positive effect of giving prominence to the patient experience and point of view, they suggest abandoning these misleading terms, favoring the use of "patient's subjective health status" and passing from the utilitarian to the existential approach.

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