The Gerontologist
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Table 3. Application of the IOM Process to End-of-Life Care

Step Action
1: Develop conceptual frameworks Specification of key variables Determination of relationships among variables
Definition of distinction between quality of life and quality of dying or death
Separation of symptom clusters
2: Measure selection Determination of reliability, validity, feasibility, and precision
Adaptation of existing measures
Development of new comprehensive measures
Determination of cultural appropriateness of measures
3A: Determine settings and timing of data collection Selection of settings of care
Designation of timing of data collection
3B: Determine data sources Selection of national data sets
Selection of patients and proxies
Determination of validity and reliability of proxy reports
Examination of case finding for family informants

Note: IOM = Institute of Medicine.





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