Clinical Significance of Health Status Assessment Measures in Head and Neck Cancer

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Abstract
An increased awareness of the need to incorporate health-related quality-of-life (HRQOL) information into the outcome assessment of patients with head and neck cancer (HNC) has been demonstrated by the number of recent publications addressing this issue and by a recent international conference devoted to the measurement and reporting of quality of life in HNC held in McLean, Va, in October 2002. The HRQOL outcomes are particularly important in HNC management because the various treatment modalities may offer equivalent survival but potentially different HRQOL outcomes.1 There are currently a variety of validated, HNC disease-specific quality-of-life surveys in use.2 As the use of these instruments in clinical practice and research increases, and as HRQOL scores are more frequently reported as clinical outcomes in the literature, it will be important for clinicians and researchers to be able to interpret these scores in a clinically useful way. For that to happen, two fundamental conditions must be met. First, data must be presented in formats that are clinically meaningful. The comparison of mean HRQOL scores representing abstract domains of health functioning rarely imparts a clinically useful message. Second, the magnitude of clinically significant intragroup changes or intergroup differences in HRQOL scores needs to be determined and reported. The simple reporting of a difference in HRQOL scores between 2 groups of patients rarely gives the clinician information that can be acted on.