20:T40e,HEALTH-related quality of life (HRQL) is increasingly used as an outcome in clinical trials, effectiveness research, and research on quality of care. Factors that have facilitated this increased usage include the accumulating evidence that measures of HRQL are valid and "reliable,"¹the publication of several large clinical trials showing that these outcome measures are responsive to important clinical changes,^2-5and the successful development and testing of shorter instruments that are easier to understand and administer.^6-13Because these measures describe or characterize what the patient has experienced as the result of medical care, they are useful and important supplements to traditional physiological or biological measures of health status. Given this improved ability to assess patients' health status, how can physicians and health care systems intervene to improve HRQL? Implicit in the use of measures of HRQL in clinical trials and in effectiveness research is the concept that clinical21:T40e,HEALTH-related quality of life (HRQL) is increasingly used as an outcome in clinical trials, effectiveness research, and research on quality of care. Factors that have facilitated this increased usage include the accumulating evidence that measures of HRQL are valid and "reliable,"¹the publication of several large clinical trials showing that these outcome measures are responsive to important clinical changes,^2-5and the successful development and testing of shorter instruments that are easier to understand and administer.^6-13Because these measures describe or characterize what the patient has experienced as the result of medical care, they are useful and important supplements to traditional physiological or biological measures of health status. Given this improved ability to assess patients' health status, how can physicians and health care systems intervene to improve HRQL? Implicit in the use of measures of HRQL in clinical trials and in effectiveness research is the concept that clinical22:T404,This article presents additional psychometric data and a revised scoring procedure for the widely used Impact on Family Scale. The analyses were conducted with three datasets produced by validation studies conducted at the originating institution with populations drawn from the same inner-city communities as the original sample. The instrument has one robust factor representing overall family impact. In addition, there are two subsidiary sets of items (financial impact and sibling impact) of possible interest to future researchers. The correlation of the previously published and new Total Score is .97. Data indicate that the Impact on Family Scale is an easily administered, reliable, and valid measure of a family member's perception of the effect of a child's chronic condition that can be used across diagnostic groups. The Impact on Family Scale fills a gap in the measurement of the psychological and social consequences of chronic disorders in childhood that can be useful in clinical and health services research.

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