Management of patients with rectal carcinoma. Classical outcomes and implementation of the quality of life concept into medical care

Quality of life (QL) assessment by means of standardised scales allows a va lid representation of an individual's subjective sense of well-being in thr ee dimensions: somatic (intensity and frequency of symptoms), psychological (anxiety, depression) and social (family life, employment, sexuality). The question, however, whether routine measurement, documentation and analysis of QL-data could lead to an improvement of patient care is still unsolved. Studies with a clearly defined practical goal in collaboration with physic ians and patients should help to resolve this issue. The introduction of th e QL concept into everyday clinical practice first requires that this tool is understandable and valuable to the clinician. In this respect, we propos e to integrate the factor QL into a broader outcome-concept in parallel to the classical quality indicators (outcome-criteria), to demonstrate individ ual patient's clinical and therapeutical course in the form of QL-profiles and to correlate the patient's actual clinical and psychosocial situation w ith the results of QL measurement. We illustrate the feasability of a stepw ise concept of implementation of the QL concept by demonstrating interim re sults of our field trial on regional management and care of patients with r ectal carcinoma in the county of Marburg-Biedenkopf.