Quality of Life in Patients With Supraventricular Arrhythmia

Physicians have always sought to relieve the suffering of patients and, if possible, to extend their lives. These goals may be expressed in modern terminology as improving the quality of life and reducing mortality. Although death is a definitive end point that is relatively simple to assess, quality of life is much more difficult to define and measure. Consequently, quality of life has less often been included as an outcome in clinical research, and clinicians have had little solid information about the effect of treatment on quality of life. Fortunately, more studies now include quality of life assessments, so clinicians will soon have a more complete picture of the outcomes of care. Quality of life measurement is a relatively new field in medicine1 2 3 4 that is derived from two broad schools of thought in the social sciences, which have led to two distinct approaches to measurement. Researchers grounded in the discipline of psychology have emphasized the multiple dimensions of quality of life and developed instruments that assess each dimension separately.3 5 The scales originally developed at the RAND Corporation for use in the Medical Outcomes Study exemplify this approach.6 An abbreviated version of this instrument, known as the Short Form-36 (SF-36), contains 36 items that are scored in scales assessing physical limitations, emotional health, role functioning, pain, and general health. In contrast, researchers grounded in the disciplines of economics and decision analysis have emphasized the synthesis of quality of life assessment into a single summary measure corresponding to the concept of “utility,” which incorporates both the patient's rating of his or her state of health and how the patient values that state of health.7 Health utility has been measured with a variety …