Quality of life measurement in gastrointestinal and liver disorders

Modern medicine has had a considerable impact on mortality rates for seriou s illness. Many chronic diseases which have previously been associated with an increased mortality now have survival rates approaching those of the ba ckground population. However, chronic diseases such as cancer, chronic pain syndromes, and chronic inflammatory conditions impose a considerable burde n on families, the health care system, and society. Health related quality of life (HRQOL) is a concept that has developed from the need to estimate t he impact of such chronic diseases. HRQOL measurement is a conceptual frame work which attempts to predict daily function and well being based on subje ctive attitudes and experiences of physical, social, and emotional health. It has been evaluated predominantly from the patient's viewpoint as proxy r espondents appear to underestimate the full effect of chronic illness on fu nctional status. Measuring HRQOL in clinical research is most frequently un dertaken using multi-item questionnaires to estimate daily function. Factor s which affect HRQOL can be broadly classed as disease related and disease independent. The use of different assessment techniques permits comparisons between and within disorders. Generic and disease specific instruments use d together enhance the ability to direct treatment for individuals and pati ent populations. Psychometrically sound questionnaires must be used. Howeve r, the type of instrument and research methods adopted depend on the questi on of interest. We have attempted to catalogue and critically assess the di sease specific instruments used in the assessment of chronic gastrointestin al disease.