Applications of health status assessment measures in clinical practice. Overview of the third conference on advances in health status assessment.

To what purposes can the measurement of health status and health-related quality of life in clinical practice be put? What success might be expected from such endeavors? What obstacles lie in the way of that success? This monograph reports on the proceedings of a conference (the third in a series on advances in health status assessment) convened to address those questions. It presents two papers concerned with barriers to and benefits of health status and quality-of-life measurement in clinical practice and another two on strategies for overcoming those barriers and exploiting the benefits; also included are papers on historical forces motivating the use of these measures, one special address on ethical issues, eight presentations on empirical research in clinical settings, several panel discussions, and four methods roundtables. A broad conclusion to be drawn from the conference proceedings is that good methods and tools for health status assessment are here and are being used in many ways, but mostly for purposes other than routine patient care. Enthusiasm for fostering the diffusion of assessment instruments into practice settings is real, but so are the doubts, particularly for clinicians "in the trenches" of everyday practice, that widespread understanding and use can be achieved easily or quickly. The challenge for the field is to be aware of and sensitive to the uncertainties and misgivings of those in clinical practice, to address those apprehensions through both formal research and practical tests, and to maintain the momentum of communication and collaboration carried forward by this third conference.