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 purposes.
Copyright
The DLQI is copyright world-wide and can only be reprinted with permission from the authors
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 Professor A Y Finlay directly at the address below. Formal permission is usually given immediately.
Please contact:
For general queries:
E-mail: dermqol@cf.ac.uk
Other contacts:
Dr. Mohammad K. A. Basra: BasraMK@cf.ac.uk
(Technical aspects and permission to use)
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 4721
Fax: +44 (0)29 2074 4321
There are over 500 publications describing the use of the DLQI world-wide. An updated version of this list is available from DLQI published abstracts and DLQI published articles .
Translations
If it is required to make a further translation of these Indexes into other languages it is essential that validated translations be used. At the very minimum this requires two independent translators translating the measures from English into the alternative language. These two translators then discuss their translations and agree on a single translation in the alternate language. At this stage a third and fourth translator are asked to independently back-translate the alternate language version into English. At this stage the back-translations need to be reviewed by the copyright holders. Nearly always small problems become apparent at this stage and it is necessary for further changes to be made in the alternative language translation. This then needs to be validated by a further process of back-translation. Advice on this process can be gained from the address below.
Please note that the copyright for any translation is retained by the original copyright holders and is not transferred or shared with any additional copyright holders even though they may have been involved in the translation.
Link to the Translation page
Cartoon versions
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. Please contact the authors 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.
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.
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.
