How to measure quality of life in integrative oncology research.

Quality of life is an important focus of integrative oncology research. Choice of an appropriate way to measure quality of life is therefore a key concern. A common error of researchers has been to focus on whether a quality of life measure has been "validated". This may be a necessary condition for choice of endpoint, but it is certainly not sufficient. It is easily shown that interventions that undoubtedly improve quality of life, such as Epogen for chemotherapy anemia, will not have an important impact on items in some validated quality of life scales (e.g. "I trust my doctor") and therefore will not improve quality of life scores. Investigators are advised to move beyond "validation" as a criterion for choosing quality of life endpoints and focus instead on the specific content of different potential measures. A particularly important concern is whether a prior trial showing a statistically significant difference on a specific quality of life scale is published, as this would demonstrate that scores on the scale will improve if patients respond to treatment. In many cases, it is preferable to use specific symptoms, such as pain or fatigue, as opposed to more generic quality of life scales.