Thoma A, Cornacchi SD, Lovrics PJ, Goldsmith CH, Evidence-Based Surgery Working Group. Evidence-Based Surgery. Users’ guide to the surgical literature: how to assess an article on health-related quality of life. Can J Surg 2008;51(3):215-24.


In addition to relieving clinical symptoms and prolonging survival, the primary objective of any health care intervention is to enhance quality of life (QOL) and well-being. The broader term “quality of life” can be defined as “the adequacy of people’s material circumstances and their feelings about these circumstances.” This encompasses indicators of life satisfaction, personal wealth and possessions, level of safety, level of freedom, spirituality, health perceptions and physical, psychological, social and cognitive well-being.

Health-related quality of life (HRQL), a subcomponent of QOL, comprises all areas specific to health, that is, physical, emotional, psychological, social, cognitive and role functioning, as well as abilities, relationships, perceptions, life satisfaction and well-being. It refers to patients’ appraisals of their current level of functioning and satisfaction with it, compared with what they perceive to be ideal.Impaired HRQL is a major reason why patients seek surgical care. Over the past 20 years, investigators have developed sophisticated instruments to measure such patientcentred outcomes as HRQL in addition to such clinical outcomes as mortality and morbidity. Surgeons increasingly use HRQL assessments to monitor patients over time, help select patients for surgery, determine the effects of surgical treatments and assist in policy decisions. HRQL outcomes are particularly relevant to surgical investigations because they can capture the impact of, and recovery from, surgery.

This paper’s purpose is to help surgeons appraise articles that appear in the surgical literature and purport to measure HRQL outcomes.

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