The Quality of Well-Being Scale: Critical similarities and differences with SF-36

Abstract

Purpose. To summarize the development and application of a generic measure of health-related quality of life known as the Quality of Well-Being Scale (QWB). Background. The QWB is part of a general health policy model. The measure includes functional components for mobility, physical activity, and social activity. In addition, it includes a comprehensive list of symptoms and problems. QWB scoring allows placement of each individual on a continuum of wellness ranging from 0 (for dead) to 1.0 for asymptomatic full function. The General Health Policy Model combines this point in time measure with information on prognosis and mortality to estimate quality-adjusted life-years (QALYs). Forming a ratio of program costs to QALYs yields estimates of cost per quality-adjusted life year. Evidence supports the validity of the QWB for a wide variety of applications in population monitoring, descriptive studies of patient populations, and clinical trials. We offer a variety of comparisons between the QWB and Medical Outcomes Study Short Form 36 (SF-36). Main findings. In comparison with the SF-36, the QWB provides less information on health profiles, but has the advantage of providing a metric that can be used for cost-utility or cost-effectiveness analysis. Although ceiling effects are common for some SF-36 subscales, perfect scores on the QWB are very rare. The QWB has an approximately normal distribution for populations of adults. Although, often criticized for not including a mental health component, we present evidence documenting the validity of the QWB for patients with psychological and psychiatric diagnoses. Conclusions. The QWB and SF-36 are alternative comprehensive measures of health outcomes.