Health-related quality of life (QOL) assessments are intended to capture the patient’s perspective on health and well-being. Even if not articulated, differences in the ways people think about their health and well-being are inherent in all patient-reported outcomes measures. The impact of changes in health status and treatment on QOL can be attenuated, amplified, or obscured by these differences. In 2004, we developed the QOL Appraisal Model and related measures to describe differences in individuals’ criteria for evaluating their own QOL. Although challenging to administer, first-generation appraisal measures have been successful in accounting for individual differences and intra-individual response shifts in QOL. More user-friendly appraisal measures that can be readily administered alongside standard patient-reported outcomes are needed and would serve to advance patient-centered research and practice.
