The quality of quality of life studies in general surgical journals

BACKGROUND: There has been a tremendous increase in interest on quality of life in surgical research. An increase in interest does not necessarily tra nslate into better research. This study evaluates surgical articles that cl aim to measure or make some conclusion on quality of life. STUDY DESIGN: All articles published in the calendar years 1996 and 1999 th at purported to assess quality of life as end points or make some conclusio n about quality of life were chosen for review from eight general surgical journals. Articles were assessed for use of a quality of life instrument, t ype of instrument, validation of the instrument, appropriateness of the ins trument for the hypothesis, quality of statistical analysis, and adherence to the Gill and Feinstein criteria. RESULTS: Of the 18 articles published in 1996, 72% used a quality of life i nstrument. Eighteen instruments were used in 13 studies: 7 generic, 10 dise ase-specific, and 1 ad hoc. Forty-three percent were validated, 39% were ap propriate for the study hypothesis, 39% had correct statistical analysis. T he majority did not meet the Gill and Feinstein criteria. Of the 24 studies published in 1999, 63% used a quality of life instrument. Twenty-two instr uments were used in 15 studies: 11 generic, 5 disease-specific, and 6 ad ho c. Fifty-five percent were validated, 45% were appropriate, 45% had correct statistical analysis. Once again, the majority did not meet the Gill and F einstein criteria. CONCLUSIONS: Despite the emphasis on quality of life outcomes, a substantia l number of studies made errors in conceptually defining quality of life an d in use of quality of life instruments. Researchers and journal reviewers need to be better versed on the techniques of quality of life research. (J Am Coll Surg 2001; 193:288-296. (C) 2001 by the American College of Surgeon s).