Response to Dr Morrish
Michael R Rose, Consultant Neurologist,
August 24, 2010
Dr Morrish is quite right to say that QoL questionnaire responses are influenced by mood. Indeed mood, but also other psycho-social factors, are liable to affect any subjective assessment. Subjective assessments include many of the patient reported outcome measures (PROMS) which are becoming increasingly popular, whether these are measuring QoL, patient satisfaction, function or other parameter. In our study the multiple regression analysis has in fact allowed us to not only control for the effects of mood on QoL but also to apportion the contribution that mood makes to QoL. As reported mood contributes 14% to the effect on QoL and the major determinant of QoL is the severity of the muscle disease. This and the fact that the profile of mood's effects on QoL differs from that of disease severity shows that QoL is not surrogate measure for mood. We have also shown that mood is only loosely correlated with the severity of the muscle disease. Appreciating these facts allows us to realise that attention to mood and other psycho-social factors in all muscle patients, whether the muscle disease is severe or not, does allow us the opportunity to improve the QoL of such patients even when the muscle disease is untreatable. Improvements in QoL achieved in this way are no less real or desirable than those that might be achieved by future disease modifying treatments.
Conflict of Interest:
Conflict of Interest