Evaluation of quality-of-life measures for use in palliative care: a systematic review.
OBJECTIVE
In this literature review we evaluated the feasibility and clinimetric quality of quality-of-life (QoL) measurement instruments suitable for use in palliative care.


METHODS
We conducted a systematic literature review to identify instruments measuring (at least one domain of) QoL. We selected articles that present data on patients receiving palliative care and at least one measurement property. A checklist was used to describe the characteristics of the instruments, and a widely accepted rating list was used to evaluate the clinimetric aspects.


RESULTS
29 instruments were identified and evaluated, most of which were targeted at palliative patients in general. None of the instruments demonstrated satisfactory results for all measurement properties. Fourteen instruments received positive ratings for construct validity. Thirteen instruments were tested for reliability, but only two were tested adequately and had positive results (ICC>0.70). Responsiveness was not tested adequately for any of the instruments. Very few of the studies provided information on the interpretation of the scores. Overall, the MQOL, followed by the QUAL-E and the QODD, received the best ratings for their measurement properties.


CONCLUSIONS
Many measurement instruments were identified, but most had not yet been adequately evaluated. The evaluation of existing instruments with good content validity should have priority over the development of new instruments.
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. g.albers@vumc.nl
Gwenda
G
Albers
Michael A
MA
Echteld
Henrica C W
HC
de Vet
Bregje D
BD
Onwuteaka-Philipsen
Mecheline H M
MH
van der Linden
Luc
L
Deliens
D017028:Caregivers / Q000523:psychology; D057189:Checklist; D016206:Databases, Bibliographic; D006801:Humans; D010166:Palliative Care; D011788:Quality of Life; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires / Q000592:standards*; D019452:Terminally Ill / Q000523:psychology