Does assessment of quality of life in comparative cancer trials make a difference? A discussion

Abstract

This paper discusses two accompanying manuscripts addressing the question whether the assessment of quality of life in comparative cancer trials makes a difference. A number of thoughts and comments stimulated by the manuscripts are presented. It is concluded that, when comparing treatment regimens for a disease such as cancer, three measures can be considered in turn. First, the primary endpoint must remain: How long do patients survive? The logical next question is: How well do patients function? Then we have the third question: How well do patients feel? Certainly, these questions are interrelated, but our decisions will be the most rational (and we will provide the most useful information to patients) if we keep these distinctions in mind. Whatever the endpoint of interest, however, the appropriate way to compare different therapeutic interventions reliably is the randomized trial.