Health-related quality of life evaluation through formal psychological assessment

Abstract

Background: General Quality of life (QOL) instruments are not suited to deeply investigate the specific features of QOL in different diseases. On the other hand, focusing on specific illness generates a multitude of separated health-related QOL (HRQOL) instruments. The aim of this project is to create a unique new tool to assist the human operator in the evaluation of the QOL in an efficient and effective way. Formal Psychological Assessment (FPA) provides a formal framework to build adaptive assessment tools. This innovative methodology has been successfully applied in different psychological clinical context (e.g., depression). Methods: We derived from the literature three main dimensions (physical functioning, psychological well-being, and social well-being) with their respective sub-dimensions. In line with FPA a mapping from items (retrieved from existing QOL and HRQOL instruments) to QOL sub-dimensions was defined (formally a Boolean matrix) in order to analyze the relations among them. Results: While none of the considered questionnaires could alone cover all the selected QOL sub-dimensions, we also observed that some items were repeated or not needed to describe the construct. We provided the formal structure of a self-report tool which cover all the chosen QOL sub-dimensions and which is simultaneously adaptive (i.e., a process that mimics a semi-structured interview where the item proposed depends on the previous answer given by the subject) Discussion: Through FPA we suggested that it is possible to build a general QOL tool that can act as a specific HRQOL measure. Furthermore, it allows for computerized-adaptive assessment.