The emics and etics of quality of life assessment.

BACKGROUND: Among quality of life (QOL) researchers there is a debate over the value of subjective measures, because subjective ratings of different areas of people's lives often bear little relation to their objective life circumstances. Anthropological theory can illuminate this debate, since cultural anthropologists grapple with a similar issue--the difference between emics and etics. Emic data, in anthropology, deal with distinctions that are real and significant to natives of the culture, while etic statements depend on distinctions judged appropriate by scientific observers.
CONCLUSIONS: The study of emics and etics suggests the following conclusions for QOL researchers. Subjective and objective appraisals are different kinds of data, both of which can be collected from subjects. Both are valuable, but it may be necessary to override subjective data to develop a predictive model. Objective circumstances do not reliably predict subjective evaluations of those circumstances or vice versa, particularly in evaluating change over time. The combination of subjective and objective measures, however, can lead more directly to service improvements that are sensitive to consumers' needs.