No abstract

The results supported others showing that a significant proportion of the elderly receive care that is potentially harmful and not supported by evidence-based practice. Use of a disease-specific HRQOL scale may be more responsive to measuring the impact of potentially inappropriate drugs on patients' HRQOL.

None of the pharmacological agents tested for stuttering have been shown in methodologically sound reports to improve stuttering frequency to below 5%, to reduce stuttering by at least half, or to improve relevant social, emotional, or cognitive variables. These findings raise questions about the logic supporting the continued use of current pharmacological agents for stuttering.

These results confirm that utility estimates can differentiate between stuttering severity levels and that utility scores for stuttering conform to the known properties of data obtained using these standard measurement techniques. These techniques, therefore, can and should be further investigated as potential contributors to complete measurement protocols for the study and treatment of stuttering.

Available instruments do not satisfy psychometric criteria for use in individual or group-level decision making, either as measures of their originally intended constructs or as measures of health-related quality of life. Problems with the conceptual model, reliability, validity, and responsiveness of available instruments, as well as the lack of comprehensive normative data, combine to suggest the need for development and validation of a stuttering-specific health-related quality of life measure.