Assessing quality of life in clinical research: From where have we come and where are we going?

The term "quality of life" first surfaced in 1920, but it was not until the 1960s that it came to public notice in North America. This article describ es the history of quality of life assessment, discusses its current status, and suggests challenges for the future. The development of generic measure s began in the early 1970s and continues today. Disease-specific measures h ave also proliferated. The 1980s and 1990s saw an increase in methodologica l rigor, and additional emphasis on analytic approaches, interpretation of scale scores, cultural and language issues, as well as on the development o f shorter measures. Future challenges include conceptualization and testing of theoretical models, further refinement of individualized measures for u se in routine clinical practice, the use of computer adapted testing in qua lity of life assessment, and the inclusion of quality of life information i n health databases. (C) 1999 Elsevier Science Inc.