Cited by 3,027Health Systems, Economic Evaluations, Quality of LifeCancer survivorship and careMusculoskeletal pain and rehabilitation

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Linking Clinical Variables With Health-Related Quality of Life: A Conceptual Model of Patient Outcomes

Wilson, Ira B.·1995·JAMA

DOI 10.1001/jama.1995.03520250075037

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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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Hartman, E. E., Oort, F. J., Sprangers, M. A. G., et al. (2008) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e31815ce545 · Cited by 60
“To study which factors explain the QL of children and adolescents with ARM or HD, we have used an explanatory model, based on the Wilson and Cleary model (17) (Fig.”
Method
The level of association between functional performance status measures and patient-reported outcomes in cancer patients: a systematic review
Atkinson, T. M., Andreotti, C., Roberts, K. E., Saracino, R. M., Hernandez, M., & Basch, E. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-015-2923-2 · Cited by 60
“FPS refers to a patient’s ability to perform activities and functions that meet basic physical needs in the face of illness [2].”
Background
A Systematic Review of Patient-Reported Outcome Measures Used in Adult Burn Research
Griffiths, C., Guest, E., White, P., Gaskin, E., Rumsey, N., Pleat, J., & Harcourt, D. M. (2016) · Journal of Burn Care & Research · doi:10.1097/bcr.0000000000000474 · Cited by 60
Pain and health-related quality of life in people with chronic leg ulcers
Hopman, W. M., Buchanan, M., VanDenKerkhof, E. G., & Harrison, M. B. (2013) · Chronic diseases and injuries in Canada · doi:10.24095/hpcdp.33.3.07 · Cited by 58
A simple score for assessing stable chronic obstructive pulmonary disease
Esteban, C., Quintana, J. M., Aburto, M., Moraza, J., & Capelastegui, A. (2006) · QJM · doi:10.1093/qjmed/hcl110 · Cited by 59
“In building our score index, we provided a model that takes into account physiological factors (FEV1), symptoms (dyspnoea), physical function (activity level) and general health (overall health impression).(28) We wanted this score to be easy to assemble and quick and simple to administer.”
Method
Assessing quality-of-life outcomes in cardiovascular clinical research
Mark, D. B. (2016) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.10 · Cited by 63
The ECOS-16 questionnaire for the evaluation of health related quality of life in post-menopausal women with osteoporosis
Badia, X. C., Díez‐Pérez, A., Lahoz, R., Lizán, L., Nogués, X., & Iborra, J. (2004) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-2-41 · Cited by 57
“This finding is not new [ 19 ,20] and suggests that HRQoL scores could be influenced by other factors such as personal, clinical and sociodemographic characteristics.”
Supervised toothbrushing and oral health education program in Kuwait for children and young adults with Down syndrome
Shyama, M., Al‐Mutawa, S. A., Honkala, S., et al. (2003) · Special Care in Dentistry · doi:10.1111/j.1754-4505.2003.tb01668.x · Cited by 59
The effect of denture quality attributes on satisfaction and eating difficulties
Anastassiadou, V., & Heath, M. (2006) · Gerodontology · doi:10.1111/j.1741-2358.2006.00094.x · Cited by 59
Choosing patient-reported outcome measures for cancer clinical research – Practical principles and an algorithm to assist non-specialist researchers
Luckett, T., & King, M. T. (2010) · European Journal of Cancer · doi:10.1016/j.ejca.2010.08.002 · Cited by 60
Quality of Life Impact of Urge Incontinence in Older Persons: A New Measure and Conceptual Structure
DuBeau, C. E., Kiely, D. K., & Resnick, N. M. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb01295.x · Cited by 59
Outcome reporting in bariatric surgery: an in‐depth analysis to inform the development of a core outcome set, the BARIACT S tudy
Hopkins, J. C. A., Howes, N., Chalmers, K. A., Savović, J., Whale, K., Coulman, K. D., Welbourn, R., Whistance, R. N., Andrews, R. C., Byrne, J. P., et al. (2014) · Obesity Reviews · doi:10.1111/obr.12240 · Cited by 58
“#33 stomach stapl*[TIAB] (5) #32 (gastroplasty/) (3474) #31 gastrectomy[TIAB] (14778) #30 (gastrectomy) (29477) #29 (gastroenterostomy/) (6872) #28 silicon band*[TIAB] (18) #27 (gastric band) (2254) #26 gastric band*[TIAB] (2014) #25 biliopancreatic bypass[TIAB] (51) #24 biliopancreatic diversion*[TIAB] (583) #23 bili…”
Background
Factors influencing adolescents' oral health‐related quality of life ( OHRQ o L )
Page, L. A. F., Thomson, W. M., Ukra, A., & Farella, M. (2012) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.12011 · Cited by 59
Impaired health‐related quality of life in acute myeloid leukemia survivors: a single‐center study
Leunis, A., Redekop, K., Groot, C. A. U., & Löwenberg, B. (2014) · European Journal Of Haematology · doi:10.1111/ejh.12324 · Cited by 58
“Several factors that are possible associated with HRQOL in patients with AML have been identified based upon theoretical HRQOL models found in the literature (27, 28).”
Background
Validation of the SF-36 as a measure of postoperative recovery after colorectal surgery
Antonescu, I., Carli, F., Mayo, N. E., & Feldman, L. S. (2014) · Surgical Endoscopy · doi:10.1007/s00464-014-3577-8 · Cited by 58
“This may reflect the fact that postoperative recovery is in fact a complex and multi-dimensional construct that requires assessment of several interrelated and increasingly complex dimensions [12, 13].”
Background
Self-management health education for chronic HIV infection
Gifford, A. L. (1999) · AIDS Care · doi:10.1080/09540129948243 · Cited by 57
The Meaning of Food and Eating among Home Parenteral Nutrition–Dependent Adults with Intestinal Failure: A Qualitative Inquiry
Winkler, M. F., Wetle, T. T., Smith, C. E., Hagan, E., Maillet, J. O., & Touger-Decker, R. E. (2010) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2010.08.002 · Cited by 58
Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study
the PROMISE-EBF Study Group, Wandera, M., Engebretsen, I. M. S., Rwenyonyi, C. M., Tumwine, J. K., & Åstrøm, A. N. (2009) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-7-89 · Cited by 57
Menopause-Specific Quality of Life among Emirati Women
Smail, L., Jassim, G., & Rai, A. S. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010040 · Cited by 58
“Wilson and Clearly [6] have illustrated the relationships between cultural attitudes, environmental changes, hormonal changes, menopausal symptoms, change in family composition, and declining Int.”
Background
Using Conjoint Analysis to Evaluate Health State Preferences
Szeinbach, S. L., Barnes, J. H., McGhan, W. F., Murawski, M. M., & Corey, R. (1999) · Drug Information Journal · doi:10.1177/009286159903300326 · Cited by 60
Validating Measures of Pediatric Health Status, Functional Status, and Health-Related Quality of Life: Key Methodological Challenges and Strategies
Drotar, D. (2004) · Ambulatory Pediatrics · doi:10.1367/a03-101r.1 · Cited by 58
Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study
Henry, M., Albert, J. G., Frenkiel, S., Hier, M., Zeitouni, A., Kost, K., Mlynarek, A., Black, M., MacDonald, C., Richardson, K., et al. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.816587 · Cited by 57
Determinants of Health‐Related Quality of Life in Children Newly Diagnosed With Juvenile Idiopathic Arthritis
Seid, M., Huang, B., Niehaus, S., Brunner, H. I., & Lovell, D. J. (2013) · Arthritis Care & Research · doi:10.1002/acr.22117 · Cited by 58
“Conceptual framework showing causal cascade of medical factors affecting health-related quality of life, the hypothesized nonmedical factors, and potential treatment targets and clinical interventions (7,8).”
Background
Temporal Predictors of Health-Related Quality of Life in Elderly People with Diabetes: Results of a German Cohort Study
Maatouk, I., Wild, B., Wesche, D., Herzog, W., Raum, E., Müller, H., Rothenbacher, D., Stegmaier, C., Schellberg, D., & Brenner, H. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031088 · Cited by 54
Interplay between sepsis and chronic health
Yende, S. P., Iwashyna, T. J., & Angus, D. C. (2014) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2014.02.005 · Cited by 60
Correlates of health-related quality of life among lower-income, urban adults with congestive heart failure
Clark, D. O., Tu, W., Weiner, M., & Murray, M. D. (2003) · Heart & Lung · doi:10.1016/j.hrtlng.2003.07.005 · Cited by 57
Health related quality of life in older Mexican Americans with diabetes: A cross-sectional study
Graham, J. E., Stoebner-May, D., Ostir, G. V., Snih, S. A., Peek, M. K., Markides, K. S., & Ottenbacher, K. J. (2007) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-5-39 · Cited by 57

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
DOI: 10.1001/jama.1995.03520250075037
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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Linking Clinical Variables With Health-Related Quality of Life: A Conceptual Model of Patient Outcomes

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