B. Zarins replies:Dr. Anderson and Dr. Irrgang make excellent points in their critique of the
editorial. Validated questionnaires are useful if applied correctly, and they
are better than traditional methods of gathering subjective information from
patients. The point of the editorial, however, was that the pendulum has swung
too far. Validated questionnaires are being used independently as sole
measures of outcomes and are sometimes applied inappropriately.Using health-related quality of life as the primary outcome measure of the
success of a knee operation could lead to erroneous conclusions. Many factors
influence the quality of life, most of which have nothing to do with the knee.
To evaluate the result of a knee operation, I think we can get information
that is more meaningful if we study the quality of knee function rather than
the quality of life.