Ichthyosis Support Group

Dermatology Life Quality Index (DLQI)

Members tell us that often the perception of having ichthyosis, or indeed other skin conditions, by the public and even medical professionals, is that it is “just a bit of dry skin”. In reality to many patients it certainly is not “just a bit of dry skin”.

The following information is taken from Cardiff University School of Medicine, Department of Dermatology website. Department of Dermatology, Cardiff University, DLQI

What is the DLQI?

The Dermatology Life Quality Index or DLQI, developed in 1994, was the first dermatology-specific Quality of Life instrument. It is a simple 10-question validated questionnaire which has been used in 33 different skin conditions in 32 countries and is available in 55 languages. Its use has been described in over 500 publications including 30 multinational studies. At present the DLQI is the most frequently used instrument in studies of randomised controlled trials in dermatology.

The DLQI is a simple self-administered, easy and user-friendly validated questionnaire used to measure the health-related quality of life of adult patients suffering from a skin disease. Developed in 1994, the DLQI was the first dermatology-specific Quality of Life instrument. The DLQI may be used for routine clinical use by clinicians in order to assist the clinical consultation, evaluation and clinical decision making process.
It consists of 10 questions concerning patients’ perception of the impact of skin diseases on different aspects of their health related quality of life over the last week.  It has been validated for adult dermatology patients aged 16 years and older. The items of the DLQI encompass aspects such as symptoms and feelings, daily activities, leisure, work or school, personal relationships and the side effects of treatment.
Each question is scored on a 4-point Likert scale: Not at all/Not relevant=0, A little=1, A lot=2 and Very much=3.  Scores of individual items (0-3) are added to yield a total score (0-30); higher scores mean greater impairment of patient’s QoL.

I am a patient. Can I use the DLQI?

Yes, the DLQI may be used by individual patients in order to help their communication with their physicians. There is no need to ask for permission and there is no charge.

What are the different subscales/dimensions of the DLQI and how do you score these?

The DLQI has been created as a single index. However, arbitrarily the 10 questions can be categorised (and analysed) under six subscales or dimensions as follows:

• Symptoms and feelings
• Daily activities
• Leisure
• Work and School
• Personal relationships
• Treatment

How is the DLQI scored?

The scoring of each answer is as follows:

The DLQI is calculated by adding the score of each question. The maximum score is 30 and the minimum is 0. The higher the score, the more quality of life is impaired. The DLQI can be expressed as a percentage of the maximum possible score of 30 but we do not recommend this because the “original” score is much easier to understand.

Please Note: 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 also be analysed under six headings or dimensions as follows:

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

How do you handle missing data from DLQI?

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

• 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.
• If two or more questions are left unanswered the questionnaire is not scored.
• If question 7 is answered ‘yes’ this is scored 3 even if in the same question one of the other boxes is ticked.
• 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 two or more response options are ticked for one question, the response option with the highest score should be recorded.
• If there is a response between two tick boxes, the lower of the two score options should be recorded.
• 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.

Is the DLQI applicable to children?

No, the DLQI is relevant to people aged 16 years or above. However there are variations of the DLQI available suitable for children (CDLQI) and families (FDLQI).

Is there any need to get permission for the use of the DLQI?

There is no need to seek specific permission for using the DLQI in routine clinical practice 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

What are the terms and conditions for the 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.

For more information on any of the DLQI’s or to download the questionnaire please visit www.dermatology.org.uk/quality/dlqi/quality-dlqi.html