Quality-of-Life Measurement in Randomized Clinical Trials in Breast Cancer: An Updated Systematic Review (2001–2009)

Health-related quality of life (QOL) is now commonly incorporated into the design of clinical trials as a primary or secondary outcome. In 1993, QOL was defined broadly by the World Health Organization as an “individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad-ranging concept affected in a complex way by the persons’ physical health, psychological state, level of independence, social relationships, and their relationship to salient features of their environment” (1). In 1989, Moinpour et al. (2) suggested