CHANGE IN QUALITY-OF-LIFE AS AN INDEX OF CLINICAL COURSE IN DISEASE -COMPARISON OF 2 INSTRUMENTS

Quality of life is an important outcome measurement to judge disease i mpact and response to treatment; however it is very difficult to measu re. We compared the MacKenzie's Change in Maximal Function Index (CMFI ) with the Change in Quality of Life index (CQLI) developed by our gro up. Both indices were applied on admission and upon discharge of 23 me dical and surgical inpatients. The CQLl's interobserver reliability wa s somewhat better (Ri = 0.69) than that of the CMFI (Kw = 0.49). Both indices correlated with patient, close relative and physician assessme nts (rs = 0.52 to 0.86, p < 0.05). There was no correlation with Karno fsky scores. Both showed adequate responsiveness with Guyatt's coeffic ients between 2 and 4. Ninety five percent of the patients thought the questionnaires were easy to answer and approximately 5 minutes were e nough to complete them. Both indices seem to perform better when appli ed by a social worker than when applied by a physician. Our results su ggest that it is feasible to obtain consistent estimates of changes in quality of life. Either one of these indices may be used to assess th e impact of medical intervention.