Health-related quality of life in neurology

Context: In a climate of growing concern about costs of health care, profes sional accountability, and the effectiveness and efficiency of treatment, n eurologists should understand measures of health-related quality of life (H RQoL) and appreciate both their values and their limits. Objective: To provide a critical review of current concepts in the measurem ent of HRQoL, with particular emphasis on those pertaining to neurologic co nditions. Design: A selective overview of measurement strategies and specific instrum ents. Setting: Clinical and research settings. Participants: Special attention to people with such conditions as multiple sclerosis and Parkinson disease. Main Outcome Measures; The utility and relevance to neurologists of availab le measures of HRQoL. Results: There are both generic and condition- or disease-specific measures of HRQoL. Though many measures do not elicit response or are even offensiv e to people with such conditions as multiple sclerosis and Parkinson diseas e, other measures pertain directly to their circumstances and needs. Conclusions: Measures of HRQoL are both meaningful and relevant to neurolog ists. However, they must be refined-enabled-and used in combinations to add ress the clinical and existential realities of many neurologic conditions.