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Dermatology Life Quality Index

Information & conditions concerning use

Clinical use of the DLQI

The DLQI may be used for routine clinical use by clinicians in order to assist the clinical consultation, evaluation and clinical decision making process. There is no need to seek specific permission for this and there is no charge for the use of the DLQI in this context. However it is a requirement that every copy of the DLQI, in whatever language, should always reprint at the end of the DLQI, the following copyright statement:

© A Y Finlay, G K Khan April 1992 www.dermatology.org.uk The above permission does not affect the requirement for seeking of permission and of possible payment when the DLQI is used for research or other purposes.


Copyright

The DLQI is copyright world-wide and can only be reprinted with permission from the authors

 

Use by undergraduate or postgraduate students

Undergraduate students (including medical students) and postgraduate students undertaking a higher degree can use the DLQI in their research projects without seeking permission, provided that the projects are not externally funded, for example by a pharmaceutical company.  However it is a requirement that all copies of the DLQI, in any language, must reproduce the copyright statement (se above) at the end of every copy of the DLQI.


The USA Library of Congress Registration
Number: TXU 608406 Registration Date: 6 December 1993

Authors
Professor A Y Finlay and Dr G K Khan

The copyright statement
© Dermatology Life Quality Index. A Y Finlay, G K Khan, April 1992 www.dermatology.org.uk. This must not be copied without the permission of the authors.

The copyright statement must always be reprinted at the end of every copy of these questionnaires in whatever language.


Permissions

There is a simple method for getting formal permission for use of the DLQI. Please contact Mrs Joy Hayes (HayesJ@cf.ac.uk) or contact Dermqol@cf.ac.uk. Formal permission is usually given immediately.


Please contact:

For general queries, technical aspects and permission to use:

E-mail: dermqol@cf.ac.uk


Other contacts:

Mrs Joy Hayes (financial aspects): HayesJ@cf.ac.uk

Professor Andrew Y Finlay: FinlayAY@cf.ac.uk

Address:

Department of Dermatology
Cardiff University School of Medicine
Heath Park, Cardiff
CF14 4XN
United Kingdom
Te: +44 (0)29 2074 2884
Fax: +44 (0)29 2074 4321

There are over 1000 publications describing the use of the DLQI world-wide. An updated list of Articles Describing Its Use is available.


Translations

There are many validated translations availiabe.

Link to the Translation page

Cartoon versions


Translation guidelines

Strict translation guidelines are followed in order to ensure high quality translations are available.

Link to the Translation guidelines (PDF Version)


Charges

There is a small charge for the use of the DLQI (Except where the DLQI is used for routine clinical purposes). This charge is based upon the total number of patients to whom the Index is administered. It is not based upon the frequency with which the questionnaires are administered to each individual patient.

These charges are always waived by the copyright holders for non-funded 'academic' studies and they are mainly applied to pharmaceutical companies using these Indexes in Phase II and Phase III studies. There may be charges for other uses of the DLQI, for example for distribution of printed copies or for use on-line. Please contact us concerning this. The charge per patient is as follows:

UK: £5.00
USA and rest of world: $9.50
Payment should be made upon receipt of an invoice from the Cardiff University.
(Please note that for companies based within the European Union, VAT may be payable)


Instructions for use

Dermatology Life Quality Index (DLQI)
The Dermatology Life Quality Index questionnaire is designed for use in adults, i.e. patients over the age of 16. It is self explanatory and can be simply handed to the patient who is asked to fill it in without the need for detailed explanation. It is usually completed in one to two minutes.


Scoring

The scoring of each question is as follows:

Very much scored 3
A lot scored 2
A little scored 1
Not at all scored 0
Not relevant scored 0
Question unanswered scored 0
Question 7: "prevented work or studying" scored 3

The DLQI is calculated by summing the score of each question resulting in a maximum of 30 and a minimum of 0. The higher the score, the more quality of life is impaired. The DLQI can also be expressed as a percentage of the maximum possible score of 30.

**Please Note: That the scores associated with the different answers should not be printed on the DLQI itself, as this might cause bias**


Meaning of DLQI Scores

0-1 = no effect at all on patient's life
2-5 = small effect on patient's life
6-10 = moderate effect on patient's life
11-20 = very large effect on patient's life
21-30 = extremely large effect on patient's life


Detailed analysis of the DLQI

The DLQI can be analysed under six headings as follows:

Symptoms and feelings Questions 1 and 2 Score maximum 6
Daily activities Questions 3 and 4 Score maximum 6
Leisure Questions 5 and 6 Score maximum 6
Work and School Question 7 Score maximum 3
Personal relationships Questions 8 and 9 Score maximum 6
Treatment Question 10 Score maximum 3

The scores for each of these sections can also be expressed as a percentage of either 6 or 3.


Interpretation of incorrectly completed questionnaires

There is a very high success rate of accurate completion of the DLQI. However, sometimes subjects do make mistakes.

1. If one question is left unanswered this is scored 0 and the scores are summed and expressed as usual out of a maximum of 30.
2. If two or more questions are left unanswered the questionnaire is not scored.
3. If question 7 is answered 'yes' this is scored 3. If question 7 is answered 'no' or 'not relevant' but then either 'a lot' or 'a little' is ticked this is then scored 2 or 1. If it is answered 'no', but the second half is left incomplete, the score will remain 0.
4. If two or more response options are ticked, the response option with the highest score should be recorded.
5. If there is a response between two tick boxes, the lower of the two score options should be recorded.
6. The DLQI can be analysed by calculating the score for each of its six sub-scales (see above). When using sub-scales, if the answer to one question in a sub-scale is missing, that sub-scale should not be scored.


Minimal Clinically Important Difference of the DLQI

In order to help the clinical interpretation of the DLQI scores a banding system (consisting of 5 bands) has been validated. According to this system, a DLQI score 0-1 = no effect at all on patient's life DLQI score of 2-5 = small effect on patient's life, DLQI score of 6-10 = moderate effect on patient's life, DLQI score of  11-20 = very large effect on patient's life, DLQI score of  21-30 = extremely large effect on patient's life.

The Minimal Clinically Important Difference (MCID) of the DLQI in inflammatory skin diseases (range=2.2-6.9) has been estimated in 5 studies. For details please refer to the following article:

Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008; 159:997-1035.

For general inflammatory skin conditions a change in DLQI score of at least 4 points is considered clinically important (based on our latest published data). This means that a patient's DLQI score has to either increase or decrease by at least 4 points in order to suggest that there has actually been a meaningful change in that patient's quality of life since the previous measurement of his/her DLQI scores.


Key References

Finlay A Y, Khan G K. Dermatology Life Quality Index (DLQI): A simple practical measure for routine clinical use. Clinical and Experimental Dermatology 1994; 19: 210-216.

Lewis V L, Finlay A Y. Ten years experience of the Dermatology Life Quality Index (DLQI) J Investig Dermatol Symp Proc 2004; 9(2):169-180.

Hongbo Y, Thomas C L, Harrison M A, Salek M S, Finlay A Y. Translating the Science of Quality of Life into Practice: What Do Dermatology Life Quality Index Scores Mean? J Invest Dermatol, 2005, 125:659-664.

Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008; 159:997-1035.

AY Finlay. Current severe psoriasis and the Rule of Tens. Br J Dermatol 2005; 152: 861-867.

Khilji FA, Gonzalez M, Finlay AY. Clinical meaning of change in Dermatology Life Quality Index scores. Br J Dermatol 2002; 147 (suppl 2): 50.

Kowalski J, Ravelo A, Weng E, Slaton T. Minimal Important Difference (MID) of the Dermatology Life Quality Index (DLQI) in patients with axillary and palmar hyperhidrosis. J Am Acad Dermatol 2007; 56: AB52 (P546).

Melilli L, Shikiar R, Thompson C. Minimal clinically important difference in Dermatology Life Quality Index in moderate to severe plaque psoriasis patients treated with adalimumab. J Am Acad Dermatol 2006; 54: AB221 (P2894).

Shikiar R, Harding G, Leahy Michael, Lennow RD. Minimal Important Difference (MID) of the Dermatology Life Quality Index (DLQI): Results from patients with chronic idiopathic urticaria. Health and Quality of Life Outcomes 2005; 3: 36.

Shikiar R, Willian MK, Okun MM et al. The validity and responsiveness of three quality of life measures in the assessment of psoriasis patients: results of phase II study. Health and Quality of Life Outcomes 2006; 4: 71.