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Ann Thorac Surg 2000;69:727
© 2000 The Society of Thoracic Surgeons

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Commentary

^a Cardiac Surgery Department, University Hospital Gasthuisberg, B-3000 Leuven, Belgium

e-mail: paul.sergeant{at}uz.kuleuven.ac.be

Invited commentary

This manuscript challenges clinicians and outcome analysts by integrating subjective quality of life (QOL) variables into outcome analysis. Preoperative QOL scores are used as incremental risk variables and postoperative ones are used as outcome variables.

This study is somewhat limited by the small sample size, the limited number of lethal events and the absence of complex transformations of patient variables. I might also disagree with the statement that the patient’s subjective perception of "how he feels" would be a better predictor for survival versus objective medical data.

Clinical symptoms are subjective transformations of pathophysiological dysfunctions, therefore the relation between subjective and objective variables needs to be strong but not "one to one." Subjective variables will enrich the patient’s description. The science of outcome analysis has demonstrated the prime importance of the availability of the original non-transformed variables (subjective or objective) and the identification of the appropriate transformation in the search of the optimal relation with the studied event.

Clinicians weathered by the crude realities of medicine have not always appreciated the subtleties of the "quality of life" scoring systems. This study has shown unequivicably that QOL scores will have to be included in new longitudinal datasets of cardiac surgery and cardiological patients.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Paul T. Sergeant Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sergeant, P. T. Search for Related Content PubMed Articles by Sergeant, P. T.