How well are we doing in caring for the patient with primary malignant brain tumor? Are we measuring the outcomes that truly matter? A commentary

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Neurologists, neurosurgeons, and neuroconcologists have traditionally measured clinical information about the patient that includes descriptions of mortality, morbidity, time to progression, survival time, magnetic resonance imaging data, and laboratory evaluations. These measurements have been referred to as intermediate health outcomes. They are a reflection of what is happening to the patient but do not provide a direct measurement of total impact on the patient. This paper describes the traditional means of approaching patients with malignant brain tumor. A philosophical shift to a more functional alternative approach is offered. This emphasis on functional assessment and quality of life will help to focus not only on the disease but rather on the total impact of various treatment options on the patient.

Neurologists, neurosurgeons, and neuroconcologists have traditionally measured clinical information about the patient that includes descriptions of mortality, morbidity, time to progression, survival time, magnetic resonance imaging data, and laboratory evaluations. These measurements have been referred to as intermediate health outcomes. They are a reflection of what is happening to the patient but do not provide a direct measurement of total impact on the patient. This paper describes the traditional means of approaching patients with malignant brain tumor. A philosophical shift to a more functional alternative approach is offered. This emphasis on functional assessment and quality of life will help to focus not only on the disease but rather on the total impact of various treatment options on the patient.

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Address reprint requests to: Jay Rosenberg, M.D., 5852 Corral Way, La Jolla, California 92037. email: jay.rosenberg@kp.org.

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