Professor Dowie has written an interesting and\ud thought provoking paper on a long lasting debate\ud in the literature on measuring health related\ud quality of life. The debate between generic and\ud condition specific measures (CSMs) has not\ud progressed a great deal with time and he is\ud right to question a purely psychometric approach\ud that currently tends to focuses on effect sizes.\ud He has also presented an interesting challenge\ud to the compromise solution suggested by a number\ud of psychometricians to adopt both types of\ud measure.\ud