The use of quality of life data in clinical practice.

A large amount of quality of life (QoL) information has been and is being collected in the oncology setting but it is unclear how such data influence decisions about the management of individual patients. A questionnaire designed specifically for the study was mailed to 260 senior oncologists to investigate how QoL data are being used outside the context of cancer clinical trials; replies were received from 154 (59%). Approximately 80% believed QoL information should be collected prior to the commencement of treatment, but less than 50% actually did so. Similarly, less than 50% assessed QoL as a method of monitoring the responses to treatment even when the treatment goal was palliation. The barriers to collecting such data were time and resource constraints, perceived lack of an appropriate instrument and a belief that QoL assessments were unnecessary. Other than making a subjective assessment based on examination and history, 73 (47%) used either standardized questionnaires or a system derived in their unit to assess the QoL of their patients. Given an appropriate instrument the majority believed that QoL data could be collected on a routine basis. The main barriers to collecting QoL data are logistic and the challenge remains to develop a method of collecting and analysing QoL information in a manner which enhances decision making.