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Linking Clinical Variables With Health-Related Quality of Life: A Conceptual Model of Patient Outcomes
Abstract
HEALTH-related quality of life (HRQL) is increasingly used as an outcome in clinical trials, effectiveness research, and research on quality of care. Factors that have facilitated this increased usage include the accumulating evidence that measures of HRQL are valid and "reliable,"1the publication of several large clinical trials showing that these outcome measures are responsive to important clinical changes,2-5and the successful development and testing of shorter instruments that are easier to understand and administer.6-13Because these measures describe or characterize what the patient has experienced as the result of medical care, they are useful and important supplements to traditional physiological or biological measures of health status. Given this improved ability to assess patients' health status, how can physicians and health care systems intervene to improve HRQL? Implicit in the use of measures of HRQL in clinical trials and in effectiveness research is the concept that clinical
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“Symptoms and side effects are the most proximally and least confounded clinical variables associated with disease and treatment; however, as one moves further away from the direct effects of disease and treatment, towards the broader construct of quality of life, many other confounding patient and environmental factors influence a quality of life score.”
In the citing paper
“The model suggests that to be very precise and valid, distinctly different PROs should be assessed separately to maximize information and decrease overlap between constructs.”
In the citing paper
“Per Wilson and Cleary, HRQOL is a broad, multi-faceted construct affected by many confounding variables [16].”
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“MEASURES In selecting measures to include as independent variables in our models of health and functional status outcomes, we have followed the direction of many previous reports (Johnson & Wolinsky, 1993; Patrick & Bergner, 1990; Wilson & Cleary, 1995).”
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Metadata
- Authors
- Wilson, I. B.
- Corresponding author
- Wilson, Ira B.
- ORCID
- Wilson, Ira B.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1995-01-04
- Volume
- 273
- Issue
- 1
- Pages
- 59
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4292024189
- Cited by
- 3,027
- References
- 0
- Citations by year
- 2026: 151 · 2025: 168 · 2024: 134 · 2023: 141 · 2022: 176 · 2021: 183 · 2020: 197 · 2019: 137 · 2018: 138 · 2017: 130 · 2016: 145 · 2015: 131 · 2014: 128 · 2013: 123 · 2012: 106
- FWCI
- 96.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (1-R01-HS06239)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- health-related quality of life, clinical factors, patient-reported outcomes, outcome measures, quality of care, effectiveness research, health assessment
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