Improved Quality of Life General (QGEN®) Short Form Survey Published by JWRG

The shortest possible, comprehensive patient reported outcome (PRO) short form, QGEN®-8, uses a single newly constructed item to measure each of the eight most frequently measured generic health-related quality of life (HRQOL) domains more broadly and over a wider range of score levels [MORE].

The shortest possible patient reported outcome (PRO) survey with an improved single-item-per-domain (SIPD) scale for each of the eight most frequently measured health-related quality of life (HRQOL) outcomes has been published by JWRG. For all four Medical Outcomes Study (MOS) short form (SF) functioning domains, new QGEN® items increase response category ranges and raise the “ceiling” by redefining the most favorable activity level as “Easy to do” in place of the legacy “Not at all limited” category. For bipolar (ill- vs well-being) domains, a new SIPD item was constructed to directly measure both of the opposite poles of each higher-order factor previously measured by multiple items, for example: one item for Mental Health (psychological distress vs well-being) and one item for Vitality (feeling energetic vs. worn out). The practical implications of QGEN, demonstrated in general and chronically ill US and international population research, include:

  • Improved overall item efficiency in terms of information/item and reduced respondent burden (by 75%, < 1 minute for most adults);
  • Increased score range enough to significantly lower percentages scoring at the highest level (reduced ceiling effects); and
  • Satisfactory convergent and discriminant validity in comparison with the best legacy SIPD and multi-item scales measuring common domains.

As with all MOS short forms, higher scores indicate better health related functioning and well-being. Specifically, scores are transformed to have mean=50 and SD=10 in a true probability sample representing 97% of the general US population surveyed by NORC. Thus, with standardized norm-based scoring, QGEN items also provide unbiased estimates of average scores observed for the profile of MOS multi-item measures of the same domains as well as accurate estimates of SF-36 physical (PCS) and mental (MCS) component summaries and SF-6D health utility estimates in general and chronically ill populations. This standardization enables meaningful comparisons with more than three decades of published population norms, effect sizes, minimally important differences, and other proven interpretation guidelines.

A practical advantage of QGEN is its efficiency. In comparison with SF-36 and comparable (e.g., PROMIS) multi-item short-forms measuring the same domains, the eight-item QGEN reduces survey administration time by more than 75%, to about 1 minute for most respondents. This makes it possible to maintain comparability with the metrics most widely used in clinical practice and research for essential QOL domains in general population and clinical surveys with severe respondent burden constraint.


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