The University of Washington Quality of Life Scale

  • S. N. Rogers
  • D. Lowe


The need for validated head and neck specific cancer health-related quality of life (HRQOL) questionnaires has long been recognised. One of the first to be published was the University of Washington quality of life scale (UW-QOL) in 1993. The current version 4 covers 12 domains - pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function, taste, saliva, mood and anxiety. Each question is scaled from 0 (worst) to 100 (best) according to the hierarchy of response. The UW-QOL also contains three global questions, one as a five-point Likert scale asking about HRQOL compared to the month before the cancer, and the other two as a six-point Likert scale, one asking about health-related and the other asking about overall quality of life during ‘the past 7 days’. It also has a question asking about the importance of domains and an option for free-text comment.

The lack of any copyright agreements and its simplicity in scoring makes using the UW-QOL questionnaire easy to use. It has been translated into numerous languages. The questionnaire has face and content validity and there is considerable evidence to support the construct validity of its domains. Our work indicates the UW-QOL to be sensitive to changes in patient characteristics and to changes over time. The identification of suitable cut-offs in domain scores adds to the interpretability of the UW-QOL in a routine clinic setting to help screen patients with particular problems. The UW-QOL displays stability in patients beyond one year from treatment and shows expected differences in regard to normative values. Factor analyses indicate that two composite scores – physical function and social function – are logical, each being a simple average of 6 domain scores. Further work is necessary to develop a better understanding of these composite scores, which have the potential of being used to assess clinical effect in treatment evaluation studies and to develop sample size calculations.


Composite Score Domain Score Percutaneous Endoscopic Gastrostomy Shoulder Function Emotional Function 

List of Abbreviations:


Beck Depression Inventory


Centre for Epidemiology Studies Depression Scale


Derriford Appearance Scale


European Organisation for Research and Treatment of Cancer




Functional Assessment of Cancer Therapy


Fibreoptic Endoscopic Evaluation of Swallowing


Hospital Anxiety and Depression Scale


Health-Related Quality of Life


Intensity Modulated Radiotherapy


Liverpool Oraql Rehabilitation Questionnaire


M.D.Anderson Dysphagia Inventory


Neck Dissection Impairment Index


Shoulder Disability Questionnaire


medical outcomes study 36-item Short-Form health survey


Sickness Impact Profile


Swallowing Quality of Life measure


Therapy Outcome Measures


University of Washington Quality of Life scale


Visual Analogue Scale


Voice Handicap Index


Voice Related Quality of Life


Xerostomia- related Quality of Life Questionnaire


  1. Al-Qahtani K, Hier MP, Sultanum K, Black MJ. (2006). Oral Surg Oral Med Oral Path Oral Rad Endo. 101: 753–756.CrossRefGoogle Scholar
  2. Andrade FP, Antunes JL, Durazzo MD. (2006). Braz Oral Res. 20: 290–296.PubMedCrossRefGoogle Scholar
  3. Campbell BH, Marbella A, Layde PM. (2000). Laryngology. 110: 895–906.Google Scholar
  4. Campbell BH, Spinelli K, Marbella AM, Myers KB, Kuhn JC, Layde PM. (2004). Otolaryngology. 130: 1100–1103.Google Scholar
  5. D’Antonio LL, Zimmerman GJ, Cella DF, Long SA. (1996). Otolaryngol Head Neck Surg. 122: 482–487.Google Scholar
  6. D’Antonio LL, Long SA, Zimmerman GJ, Peterman AH, Petti GH, Chonkich GD. (1998). Laryngology. 108: 806–811.Google Scholar
  7. D’Cruz AK, Robinson MH, Biel MA. (2004). Head Neck. 26: 232–240.PubMedCrossRefGoogle Scholar
  8. Deleyiannis FW-B Weymuller EA. (1996). Quality of life in patients with head and neck cancer In: Myers EN, Suen JY (ed.) Cancer of the Head and Neck, 3rd ed. Saunders Company, pp. 904–916.Google Scholar
  9. Deleyiannis FW-B, Weymuller EA, Coltrera MD. (1997). Head Neck 19: 466–473.PubMedCrossRefGoogle Scholar
  10. Fang WQ, Chen XY, Guan CH, Chen JF, Wang JB. (2004). Chin J Otolaryngol. 39(4): 227–231.Google Scholar
  11. Gerwin JM, Culton GL. (2005). Otolaryngol Head Neck Surg. 133(5): 685–688.PubMedCrossRefGoogle Scholar
  12. Gourin CG, McAfee WJ, Neyman KM, Howington JW, Podolsky RH, Terris DJ. (2005). Laryngology 115(8): 1371–1375.Google Scholar
  13. Hassan SJ, Weymuller EA Jr. (1993). Head Neck. 15(6): 485–496.PubMedCrossRefGoogle Scholar
  14. Hassanein KA, Musgrove BT, Bradbury E. (2001). Brit J Oral Maxfax. 39(5): 340–345.CrossRefGoogle Scholar
  15. Hassanein KA, Musgrove BT, Bradbury E. (2005). J Cranio Maxfax Surg. 33(6): 404–409.CrossRefGoogle Scholar
  16. Jha N, Seikaly H, McGaw T, Coulter L. (2000). Int J Rad Onc. 46(1): 7–11.CrossRefGoogle Scholar
  17. Jha N, Seikaly H, Harris J, Williams D, Liu R, McGaw T, Hofmann H, Robinson D, Hanson J, Barnaby P. (2003). Rad Onc 66(3): 283–289.CrossRefGoogle Scholar
  18. Kazis LE, Anderson JJ, Meehan RF. (1989). Med Care. 27: S178–189.PubMedCrossRefGoogle Scholar
  19. Kazi R, Kiverniti E, Prasad V, Venkitaraman R, Nutting CM, Clarke P, Rhys-Evans P, Harrington KJ. (2006). Clin Otolaryng. 31: 511–517.CrossRefGoogle Scholar
  20. Kazi R, De Cordova J, Kanagalingam J, Venkitaraman R, Nutting CM, Clarke P, Rhys-Evans P, Harrington KJ. (2007). J Otolaryngol 69(2): 100–106.Google Scholar
  21. Klozar J, Lischkeova B, Betka J. (2001). Eur Arch Otolaryngol. 258(10): 546–551.CrossRefGoogle Scholar
  22. Kuntz AL, Weymuller EA Jr. (1999). Laryngology. 109(8): 1334–1338.Google Scholar
  23. LoTempio MM, Wang KH, Sadeghi A, Delacure MD, Juillard GF, Wang MB. (2005). Otolaryngol Head Neck Surg. 132(6): 948–953.PubMedCrossRefGoogle Scholar
  24. Loughran S, Calder N, MacGregor FB, Carding P, MacKenzie K. (2005). Clin Otolaryngol. 30(1):42–47.PubMedCrossRefGoogle Scholar
  25. Lovell SJ, Wong HB, Loh KS, Ngo RY, Wilson JA. (2005). Head Neck. 27(10): 864–872.PubMedCrossRefGoogle Scholar
  26. Markkanen-Leppanen M, Makitie AA, Haapanen ML, Suominen E, Asko-Seljavaara S. (2006). Head Neck. 28(3): 210–216.PubMedCrossRefGoogle Scholar
  27. Mowry SE, Ho A, Lotempio MM, Sadeghi A, Blackwell KE, Wang MB. (2006a). Laryngology. 116(9): 1589–1593.Google Scholar
  28. Mowry SE, LoTempio MM, Sadeghi A, Wang KH, Wang MB. (2006b). Otolaryngol Head Neck Surg. 135(4): 565–570.PubMedCrossRefGoogle Scholar
  29. Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Karlsson U, Dutta S, Midyett A, Barloon J, Sallah S. (2005). Int J Rad Oncol Biol Phys. 61(3): 772–778.CrossRefGoogle Scholar
  30. Nitzan D, Kronenberg J, Horowitz Z, Wolf M, Bedrin L, Chaushu G, Talmi YP. (2004). Plastic Recon Surg. 114(5): 1060–1067.CrossRefGoogle Scholar
  31. Omoro SA, Fann JR, Weymuller EA, Macharia IM, Yueh B. (2006). Int J Psychiatr Med. 36(3): 367–381.CrossRefGoogle Scholar
  32. Petruzzelli GJ, Knight FK, Vandevender D, Clark JI, Emami B. (2003). Otolaryng Head Neck Surg. 129(6): 713–719.CrossRefGoogle Scholar
  33. Ringash J, Bezjak A. (2001). Head Neck. 23: 201–213.PubMedCrossRefGoogle Scholar
  34. Rogers et al. (2008).
  35. Scrimger R, Kanji A, Parliament M, Warkentin H, Field C, Jha N, Hanson J. (2007). Am J Clin Oncol 30(3): 271–277.PubMedCrossRefGoogle Scholar
  36. Smith GI, Yeo D, Clark J, Choy ET, Gao K, Oates J, O’Brien CJ. (2006). Br J Oral Maxfax Surg. 44(3): 187–192.CrossRefGoogle Scholar
  37. Smucler R, Mazanek J. (2004). Lasers Surg Med. 34(1): 12–17.PubMedCrossRefGoogle Scholar
  38. Talmi YP, Horowitz Z, Bedrin L, Wolf M, Chaushu G, Kronenberg J, Pfeffer MR. (2002). Cancer. 94(4): 1012–1017.PubMedCrossRefGoogle Scholar
  39. Thone M, Karengera D, Siciliano S, Reychler H. (2003). Revue de Stomatologie et de Chirurgie Maxillo-Faciale. 104(1): 19–24.PubMedGoogle Scholar
  40. Vartanian JG, Carvalho AL, Yueh B, Priante AV, de Melo RL, Correia LM, Kohler HF, Toyota J, Kowalski IS, Kowalski LP. (2004). Arch. Otolaryngol Head Neck Surg. 130(10): 1209–1213.PubMedCrossRefGoogle Scholar
  41. Vartanian JG, Carvalho AL, Toyota J, Kowalski IS, Kowalski LP. (2006a). Arch Otolaryngol Head Neck Surg. 132(1): 32–35.PubMedCrossRefGoogle Scholar
  42. Vartanian JG, Carvalho AL, Yueh B, Furia CL, Toyota J, McDowell JA. (2006b). Head Neck Surg. 28(12): 1115–1121.CrossRefGoogle Scholar
  43. Vigili MG, Colacci AC, Magrini M, Cerro P, Marzetti A. (2002). Eur Arch Otolaryngol. 259(1): 11–16.CrossRefGoogle Scholar
  44. Vilaseca I, Chen AY, Backscheider AG. (2006). Head Neck 28(4): 313–320.PubMedCrossRefGoogle Scholar
  45. Wang G, Ji W, Pan Z, Guo X. (2002). Chung-Hua Chung Liu Tsa Chih. Chin J Oncol. 24(1): 53–56.Google Scholar
  46. Weymuller EA, Yueh B, Deleyiannis FWB, Kuntz AL, Alsarraf R, Coltrera MD. (2000). Arch Otolaryngol Head Neck Surg. 126: 329–335.PubMedGoogle Scholar
  47. Weymuller EA Jr. Alsarraf R, Yueh B, Deleyiannis FW, Coltrera MD. (2001). Arch Otolaryngol Head Neck Surg. 127(5): 489–493.PubMedGoogle Scholar
  48. Winter SC, Cassell O, Corbridge RJ, Goodacre T, Cox GJ. (2004). Clin Otolaryngol Allied Sci. 29(3): 274–278.PubMedCrossRefGoogle Scholar
  49. Young CW, Pogrel MA, Schmidt BL. (2007). J Oral Maxfax Surg. 65(4): 706–712.CrossRefGoogle Scholar
  50. Zhang L, Luan X, Pan X, Xie G, Xu F, Liu D, Lei D. (2002). [Chinese] Chung Hua Erh Pi Yen Hou Ko Tsa Chih - Chin J Otolaryngol. 37(1): 11–14.Google Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • S. N. Rogers
  • D. Lowe

There are no affiliations available

Personalised recommendations