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(Circulation. 2008;118:2103-2110.)
© 2008 American Heart Association, Inc.

Key Issues in Outcomes Research

Evolving Applications for Patient-Centered Health Status Measures

John A. Spertus, MD, MPH

From the University of Missouri at Kansas City School of Medicine and Mid America Heart Institute, Kansas City, Mo.

Correspondence to Dr John Spertus, 4401 Wornall Rd, 5th Floor, Mid America Heart Institute, Kansas City, MO 64111. E-mail spertusj{at}umkc.edu

Patient-centered health status measures—assessments of patients’ symptoms, function, and quality of life—have matured substantially over the past 2 decades. Currently, valid, reliable, and sensitive disease-specific measures are available for quantifying the health status of patients with cardiovascular disease. This article briefly reviews the concept of health status measures, with a focus on their interpretation. It then discusses both the rationale and potential applications of health status measures in clinical care. Health status measures are not surrogate measures of outcome but rather highly meaningful outcomes of care. As such, they have important emerging roles as outcomes in clinical trials, as tools for monitoring patients in routine clinical care, as a mechanism for operationalizing and evaluating disease management programs, and as tools for quality assessment/improvement. Over time, it is expected that health status measures will also have an increasingly important role in patient-centered medical decision making. By becoming aware of the evolving roles of health status measures, clinicians can help to accelerate the realization of the Institute of Medicine’s vision for a more transparent, evidence-based, patient-centered healthcare system.

Key Words: health status • outcomes research • quality of life • review • state-of-the-art review