Evaluation of a new short generic measure of HRQoL: howRu


Quality of life is paramount for patients and clinicians, but existing measures of health were not developed for routine use. This paper describes the development and testing of a new generic tool for measuring health related quality of life (HRQoL) with direct comparison to the SF-12 Health Survey.


The new tool (howRu) has four items (discomfort, distress, disability and dependence), rated using four levels (none, a little, quite a lot and extreme), providing 256 possible states (44 ); it has an aggregate scoring scheme with a range from 0 (worst) to 12 (best). Psychometric properties were examined in a telephone survey, which also recorded SF-12.


The howRu script is shorter than SF-12 (45 words vs 294 words) and has better readability statistics. 2751 subjects, all with long-term conditions (average age 62, female 62.8%), completed the survey; 21.7% were at the ceiling (no reported problems on any dimension); 0.9% at the floor. Inter-item correlations, Cronbach’s alpha and principal factor analysis suggest that a single summary score is appropriate. Correlations between the physical and mental components of both howRu and SF-12 were as expected. Across all patients the howRu score was correlated with PCS-12 (r=0.74), MCS-12 (r=0.49) and the sum of PCS12 and MCS-12 (r=0.81). Subjects were classified by howRu score, primary condition, the number of conditions suffered, age group, duration of illness and area of residence. Across all six classi- fications, the correlation of the mean howRu score with the mean PCS-12 for each class was r=0.91, with MCS-12, r=0.45 and with the sum of PCS-12 and MCS-12, r=0.97.


HowRu is a new short generic measure of HRQoL, with good psychometric properties. It generates similar aggregate results to SF-12. It could provide a quick and easy way for practitioners to monitor the health of patients with long-term conditions.

Benson T, Whatling J, Arikan S, Sizmur S, McDonald D, Ingram D: Evaluation of a new short generic measure of HRQoL: howRu. Informatics in Primary Care 2010; 18:89-101.



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