Chronic COPD (COPD) and asthma are the most common Conditions associated with chronic airflow limitations and COPD is projected to become the 5th leading cause of years lived with disability. The recognition of the importance of systematically assessing symptoms and functional limitations to optimize the management of COPD and asthma has led to the development and use of a number of condition-specific health-status measures. A number of professional organizations in the area of cardiovascular and pulmonary medicine have reviewed the use and properties of currently available health-status measures for COPD. However, none of these organizations have made recommendations regarding the use of specific health-status measures nor provided a systematic framework that covers the spectrum of symptoms and limitations in functioning of persons with COPD.
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The prevalence of obesity is currently estimated at about 300 million people worldwide and is continuing to rise. Therefore, obesity is increasingly becoming a significant cause of disability and appears to lessen life expectancy markedly. From a societal perspective, obesity is associated with a decreased quality of life and increased healthcare costs. Based on our current understanding of obesity as a complex, multifactor condition with interactions between genetic, metabolic, environmental and personal factors, a patient-centred approach is critical for effective treatment, to measure the burden of disease and to evaluate treatment outcomes. Research has underlined the importance of measuring health status of obese patients and suggest the application of both, generic and condition-specific measures. However, no systematic framework that covers the spectrum of symptoms and problems in functioning of persons with obesity had been established at the time.
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The prevalence of diabetes mellitus in industrial countries lies between 5.9% and 8.1% and has been increasing dramatically due to increasing obesity and lack of exercise. Current recommendations for the medical treatment of DM focus primarily on the close measurement and regulation of blood sugar. In addition, symptoms related to diabetic complications should be monitored closely. A published review of health-related quality of life measurements in diabetes mellitus showed the wide variety of generic, diabetes-specific and psychological measures that had been used in patients with diabetes. However, no systematic framework that covers the spectrum of symptoms and problems in functioning of persons with diabetes mellitus had been established at the time.
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Stroke is a major public health concern, being among the most common causes of death and disability. 40–77% of patients are alive 1 year after a stroke, and many survivors face long-term disability. Stroke also imposes a substantial economic burden with direct and indirect costs estimated at $51.2 billion for 2003 in the USA. Several national and international guidelines on stroke management have been published containing recommendations on interventions and assessment strategies targeted towards the diverse areas of post-stroke disability to be considered beyond the acute phase. Although large degree of consensus exists across the different national and international guidelines, general agreement on the scope of concepts to be taken into account and on the instruments to be used in stroke disability assessment still seems to be lacking.
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Chronic ischemic heart disease is the leading cause of death worldwide and is predicted to become the leading cause of global disability-adjusted life years and the major contributor to the burden of disease worldwide by 2020. Current recommendations for the treatment of chronic ischemic heart disease focus on increasing the "quantity" of life (i.e. prevent myocardial infarction and death) and improving the quality of life (by reducing symptoms related to angina/ischemia). The importance of systematically assessing symptoms and functional limitations to optimize the management of chronic ischemic heart disease has led to the development and use of a number of condition-specific health status measures. Recently the American College of Cardiology and the American Heart Association reviewed the use and the properties of currently available health-status measures for patients with chronic ischemic heart disease.
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