Apart from the already reported, very interesting observations about home treatment and decision making by the patient/caregiver, DOSE demonstrated three key findings related to QOL. First, there are methodological limitations to the traditional periodic assessments, particularly given that baseline values are universally nonbleed days (best possible QOL). Second, patients with chronic arthropathy have more impairment in baseline QOL and have variability in nonbleed days that would likely be common with any degenerative joint disease or chronic disease characterized by an episodic course. Last, as expected, bleeding days are worse and are particularly marked by reduced patient and family activity with more pain. Thankfully, bleeding days represent a minority of the patient’s life, and there are other factors that more significantly affect overall score and day-to-day variability in the nonbleeding state. New approaches are required to adapt validated health-related QOL assessment tools for more frequent assessments that can help quantify the cumulative impact of acute bleeding associated with different treatment paradigms on the patient, as well as assess the QOL impact and burden on the caregiver and family.