But was the operation worth it? The limitations of quality of life and patient satisfaction research in health-care outcome assessment.

There is increasing recognition that clinically-derived measures of surgical outcome must be reconciled with patients' own perception of their post-treatment condition. Recently developed quality-of-life and symptom-score measures of outcome have drawn upon patients' own reports of functional status, in contrast to traditional, clinically-derived observations or technical measurements. Patient satisfaction research has been an independent growth industry whose focus has been patient feedback on quality of care received. This paper proposes that the research designs of neither tradition take full account of the personal significance, value or social meaning of a treatment for the patient, although the subject straddles both effectiveness and satisfaction. This begs the question of the value to clinicians of feedback on how worthwhile patients feel a procedure has been in their own cost-benefit terms? If this is also an important dimension of outcome assessment, the range of measures currently available cannot account for it. This paper explores possible reasons why existing patient-oriented measures address what is important to the clinician rather than the patient.