It is a reasonable first attempt. We do need better. Medicine pays too little attention to measuring patients' distress. They measure disease processes to a minute and precise degree but largely ignore quantification of illness, distress, disability. These are not new insights. Patients need the opportunity at every consultation to describe their quality of life and these sequential data need to be displayed graphically to the clinicians as a normal part of healthcare records. With the internet for remote access and touchscreen technology in healthcare settings this should be easy to implement. Only then can the assembled data be used to construct a more reliable qaly. It will come.

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