Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Health-related quality of life—an economist's perspective

Nature Clinical Practice Endocrinology & Metabolism volume 3, pages 786–787 (2007)Cite this article

Measurement of quality of life (QOL) has become a frequent addition to clinical studies in disease management: patients expect treatment to improve their health so they can return to a normal life as quickly as possible. A negative treatment effect can lead to poor compliance or treatment rejection. QOL is an important issue in chronic diseases, such as cancer or rheumatoid arthritis, as patients must live with their disease and treatment over a long period. Nonetheless, QOL must not be underestimated for acute episodes of disease. Finally, there are many examples of new treatments that demonstrate an equivalent clinical efficacy to traditional methods, but offer marked improvements in QOL. For example, recombinant human TSH (rhTSH) as an alternative stimulation method for patients with thyroid cancer is considered clinically equivalent to levothyroxine withdrawal; however, rhTSH prevents symptoms of hypothyroidism and the negative effects on QOL related to levothyroxine withdrawal.1,2

What parameters should be included when studying the effects of disease and treatment on QOL? A general agreement exists in the medical literature that what is at stake is QOL related to health problems. Indeed, many factors can affect QOL that are not related to health care. The correct term to be used, therefore, is health-related QOL (HRQOL). Experts agree that HRQOL is a subjective concept, as what must be measured is the perceived effect of disease and therapy on the individual patient. HRQOL is an intuitively logical concept; however, it is not easily captured by a unique definition and is obviously multi-dimensional. An important issue is the choice of the relevant dimensions that should be captured, and the breadth of the questionnaires used to measure these dimensions. As all diseases and treatments can differ in how they affect HRQOL, there is ongoing debate about the relevance of so-called generic questionnaires versus specific questionnaires.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Schroeder PR et al. (2006) A comparison of short-term changes in health-related quality of life in thyroid carcinoma patients undergoing diagnostic evaluation with recombinant human thyrotropin compared with thyroid hormone withdrawal. J Clin Endocrinol Metab 91: 878–884

    Article  CAS  Google Scholar 

  2. Duntas LH and Biondi B (2007) Short-term hypothyroidism after levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences. Eur J Endocrinol 156: 13–19

    Article  CAS  Google Scholar 

  3. Ware JE and Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30: 473–483

    Article  Google Scholar 

  4. Dow KH et al. (1997) Quality-of-life changes in patients with thyroid cancer after withdrawal of thyroid hormone therapy. Thyroid 7: 613–619

    Article  CAS  Google Scholar 

  5. McMillan CV et al. (2004) Design of new questionnaires to measure quality of life and treatment satisfaction in hypothyroidism. Thyroid 14: 916–925

    Article  CAS  Google Scholar 

  6. Bjordal K and Kaasa S (1992) Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol 31: 311–321

    Article  CAS  Google Scholar 

  7. Yellen SB et al. (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 13: 63–74

    Article  CAS  Google Scholar 

  8. The EuroQol group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16: 199–208

  9. Brazier J et al. (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21: 271–292

    Article  Google Scholar 

  10. Medical Services Advisory Committee. Recombinant human thyroid stimulating hormone (rhTSH)—diagnostic agent for use in well-differentiated thyroid cancer. [http://www.health.gov.au/internet/msac/publishing.nsf/Content/1043-1/$FILE/summary1043.pdf] (accessed 23 July 2007)

Download references

Author information

Authors and Affiliations

  1. G de Pouvourville is the Chair of Health Economics, ESSEC Business School, Cergy-Pontoise, France,

    Gérard de Pouvourville

  2. and M Schlumberger is a Professor in the Department of Nuclear Medicine, I Borget is a Pharmacist, Institut Gustave Roussy, Institut Gustave Roussy, Villejuif, France.,

    Isabelle Borget & Martin Schlumberger

Authors
  1. Gérard de Pouvourville
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Isabelle Borget
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Schlumberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gérard de Pouvourville.

Ethics declarations

Competing interests

Gérard de Pouvourville has received research support from Genzyme.

Martin Schlumberger is a member of the Genzyme speakers bureau.

I Borget declared no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Pouvourville, G., Borget, I. & Schlumberger, M. Health-related quality of life—an economist's perspective. Nat Rev Endocrinol 3, 786–787 (2007). https://doi.org/10.1038/ncpendmet0650

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpendmet0650

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing