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It is now widely acknowledged that the personal burden of illness cannot be described fully by measures of disease status such as size of infarction, tumour load, and forced expiratory volume. Psychosocial factors such as pain, apprehension, restricted mobility and other functional impairments, difficulty fulfilling personal and family responsibilities, financial burden, and diminished cognition must also be encompassed. The area of research that has resulted from this recognition is termed “health related quality of life.” It moves beyond direct manifestations of illness to study the patient's personal morbidity—that is, the various effects that illnesses and treatments have on daily life and life satisfaction. Although quality of life assessment was almost unknown 15 years ago, it has rapidly become an integral variable of outcome in clinical research; over 1000 new articles each year are indexed under “quality of life …