Evaluating the impact of medical care and technologies on the quality of life: A review and critique

Abstract

Recent publications by a number of critics of health care raise substantial questions about the benefits which derive from new medical technologies. The response of those who advocate these new technologies has broadened the argument, adding quality of life (QOL) considerations to previous claims which emphasize increased longevity. Unfortunately, the studies which purport to demonstrate an improved QOL do not incorporate relevant findings from a wide range of studies which emphasize the complex interplay of many subjective factors in the quantitative assessment of the QOL. There have been numerous studies of a wide range of medical interventions which employ QOL criteria. In the main, the inadequate research designs employed in these studies contrast with the sophisticated technology they purport to assess. A review of these studies indicates that few if any, procedures may be defended on the grounds that they improve the QOL. There is a need for studies involving adequately controlled samples using objective and subjective QOL indicators which address the manner in which objective QOL changes are subjectively interpreted. Until these studies become available, arguments for the impact of medical technologies on the QOL will be speculative and remain unconvincing.