important outcomes of care from patient perspectives," according to Dr. Clancy. Dr. Guyatt, et al. state, "There are three reasons we offer treatment to our patients: 1) We believe our interventions increase longevity, 2) Prevent future morbidity or 3) Make patients feel better." in recent years investigators have developed increasingly sophisticated methods for making these measurements. Physicians of all countries will have to become interested in learning how patients feel and to use methods to measure their feelings, for example: Will this treatment make my patient feel better? The following table from Guyatt et al. suggests what we should look for in studies about health quality of life. (Slide)
Guidelines for How to Use Articles About Health- Related Quality of Life (HRQL)
Are the results valid?
Primary guides
Have the investigators measured aspects of patients' lives that patients consider important?
Did the HRQL instruments work in the way they are supposed to?
Secondary guides
Are there important aspects of HRQL that have been omitted?
If there were trade-offs between quality and quantity of life, or an economic evaluation, have the investigators used the right measures?
What were the results?
What was the magnitude of effect on HRQL?
Will the results help me in caring for my patients?
Will the Information from the study help me inform my patients?
Did the study design simulate clinical practice?
Guyatt et al. Users' Guides to Medical Literature, JAMA. April 16, 1997, Vol 277. No 15.)
An infant's condition at birth and any corrective measures taken to restore him to normaIcy will have great influence on his entire life. It was necessary to learn the outcome concerning morbidity, mortality and survival of infants at high risk. As mentioned early in this presentation the most important information gained from the "Data Analysis Grant for High Risk Newborns" was the influence in application of new knowledge and
