The University of Washington Quality of Life Scale

Abstract

The need for validated head and neck specific cancer health-related quality of life (HRQOL) questionnaires has long been recognised. One of the first to be published was the University of Washington quality of life scale (UW-QOL) in 1993. The current version 4 covers 12 domains - pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function, taste, saliva, mood and anxiety. Each question is scaled from 0 (worst) to 100 (best) according to the hierarchy of response. The UW-QOL also contains three global questions, one as a five-point Likert scale asking about HRQOL compared to the month before the cancer, and the other two as a six-point Likert scale, one asking about health-related and the other asking about overall quality of life during ‘the past 7 days’. It also has a question asking about the importance of domains and an option for free-text comment. The lack of any copyright agreements and its simplicity in scoring makes using the UW-QOL questionnaire easy to use. It has been translated into numerous languages. The questionnaire has face and content validity and there is considerable evidence to support the construct validity of its domains. Our work indicates the UW-QOL to be sensitive to changes in patient characteristics and to changes over time. The identification of suitable cut-offs in domain scores adds to the interpretability of the UW-QOL in a routine clinic setting to help screen patients with particular problems. The UW-QOL displays stability in patients beyond one year from treatment and shows expected differences in regard to normative values. Factor analyses indicate that two composite scores – physical function and social function – are logical, each being a simple average of 6 domain scores. Further work is necessary to develop a better understanding of these composite scores, which have the potential of being used to assess clinical effect in treatment evaluation studies and to develop sample size calculations.