Approaches to health status assessment in hiv disease overview of the conference

Abstract

Advances in health status assessment, and the evolution of HIV into a chronic disease managed with combinations of drugs, have resulted in increased interest and application of health-related quality of life measures for people with HIVIAIDS. This monograph reports on the proceedings of a conference convened to examine the state of the art of measurement approaches for health-related quality of life in HIV disease. Investigators presented evidence for the reliability, validity, and usefulness of these measures. Papers explored psychometric and utility-based approaches to health status assessment, described and compared generic and disease-specific instruments, examined changes in scores over time, presented ways to incorporate patient preferences into health status assessments, and considered options in the analysis of profiles of scores and the reduction of dimensions. The conference highlighted convergence around a few generic approaches to health status measurement in HIV, diversity of disease-specific approaches to assessment and analysis, and a number of methodologic and practical problems yet to be resolved. In particular, further work is needed to establish the responsiveness of measures to clinically important changes, to describe the meaning of scores, to incorporate individual preferences in standardized assessments, to establish the equivalence of translated versions of questionnaires, and to analyze repeated measures data, multiple end-points, and missing data.