ABSTRACT
Health-care providers1 are placing increasing emphasis on the practice of evidence-based medicine, ‘a conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.’ Evidence-based medicine refers not only to evidence provided from research studies, including clinical trials, to guide practice in general, but also to utilization of data from the individual patient to guide his/her therapy. Three types of evidence are generally accepted for guiding treatment decisions in individual patients:
• Anatomical/biological evidence (e.g. magnetic resonance imaging, cerebrospinal fluid measurements)
• Clinical evidence (e.g. the Multiple Sclerosis Functional Composite, the Expanded Disability Status Scale)
• Patient-derived evidence
The patient-generated category of evidence may be evaluated at several levels of complexity, including general quality of life (QoL) and more specific health-related quality of life (HRQoL) or in terms of discrete patient-reported outcomes such as functional status, walking ability or self-efficacy. This chapter focuses on HRQoL assessments.
