The following are validated Patient Reported Outcome Measures (PROMs) used to measure change in general health status, acute and chronic pain, and depression while waiting for care and after surgical treatment.
The EuroQol Group 5-D Instrument (EQ-5D) is a quick instrument that is applicable to a wide range of conditions and treatments. For licensing information and to view a sample generic EQ-5D survey, please visit the Euroqol Website.
The European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) is a questionnaire that assesses the quality of life of patients with cancer. Please visit the EORTC site to view a sample and request the questionnaire.
The Impact of Weight on Quality of Life (IWQOL-Lite) assesses obesity-specific quality of life measures. To obtain the questionnaire, please visit this site.
Sample Breast-Q instruments are attached below. For information on use and licensing please visit MAPI Research Trust.
Gastrointestinal and Colorectal
Sample colorectal instruments are attached below. Many were obtained from instrument validation studies. Please obtain permission from the author prior to use.
- Gastrointestinal Quality of Life instrument (GQLI) (Eypasch et al., 1995).
- Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) (Velanovich et al.)
- The European Organization for Research and Treatment of Cancer Quality of Life – Gastric Cancer (EORTC QLQ-STO22). View a sample here and visit this website to request usage.
- Fecal Incontinence Quality of Life instrument (FIQL), and Fecal Incontinence Severity Index (FISI) (Rockwood et al., 2000).
- Core Outcome Measures Index – hernia (COMI-hernia) (Staerkle and Villiger, 2010)
- Padova Inflammatory Bowel Disease Quality of Life questionnaire (PIBDQL) (Martin et al., 1998).
- Stoma Quality of Life instrument (Preito et al., 2005)
- The European Organization for Research and Treatment of Cancer Quality of Life – Colorectal 29 (EORTC QLQ-CR29). View a sample here and visit this website to request usage.
Please obtain permission from author prior to use.
- Pelvic Floor Impact Questionnaire (Barber et al., 2005).
- Pelvic Floor Distress Inventory (Barber et al., 2005).
- Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (Rogers et al., 2003).
- Urinary Incontinence. Please visit the International Consultation on Incontinence Modular Questionnaire website for use and licensing.
- International Index of Erectile Function 5 (IIEF-5) (Rosen et al., 1999).
- Sexual Health Inventory for Men. Please visit the Pfizer Patient Reported Outcomes website to order measures.
- Expanded Prostate Cancer Index Composite Questionnaire (EPIC). Please visit the University of Michigan’s Department of Urology website to obtain the EPIC questionnaire.
Ear, Nose and Throat
- Abbreviated Profile of Hearing Aid Benefit (APHAB, form A). Please visit the HARL website to obtain the APHAB instrument.
- Sino-Nasal Outcome Test-22 (SNOT-22). Please visit the ENT-UK website to obtain the SNOT-22 instrument.
- Rhinoplasty Outcomes Evaluation (ROE) (Alsarraf).
- Foot and Ankle Ability Measure (FAAM) (Martin et al., 2005).
- Ankle Osteoarthritis Scale (AOS) (Domsic and Saltzman, 1998).
- Foot and Ankle Outcome Score (FAOS). Please visit the Knee injury and Osteoarthritis Outcome Score (KOOS) website to obtain the FAOS instrument.
Arm, Shoulder and Hand
- Disabilities of the Arm Shoulder and Hand QuickDASH Outcome Measure. Please visit the DASH Outcome Measure website to obtain the QuickDASH questionnaire.
- Patient-Rated Wrist Evaluation (PRWE) (MacDermid et al., 1998)
- Patient-rated Elbow Evaluation (PREE) (MacDermid, 2001)
- American Shoulder and Elbow Surgeons (ASES) Assessment Form (Michener, McClure, and Sennett, 2002)