Outcomes research: what to measure.

Surgeons assess the outcomes of treatment to determine if treatment is effective. The most commonly used types of outcomes have been measures of disease process (or impairment measures) because surgery is often directed toward ameliorating abnormalities of structure or function. Patient-based outcomes, such as measures of health or health-related quality of life, are necessary, however, to determine if patients have been made better by treatment. Disease-specific measures of health focus specifically on those aspects of the disease of most concern to patients, whereas generic measures of health and health-related quality-of-life measures have a much broader focus. Patient satisfaction is an additional increasingly used outcome measure. Satisfaction may be directed toward the processes of care or the outcomes of care. Satisfaction with the outcomes of care is an important secondary outcome provided the aims of treatment have been achieved and the health of patients has been improved. In conclusion, different outcomes of treatment provide different and complementary information and all have a role to play in deciding if surgical treatments are effective.