Health status (howRu)

howRu is a short generic PROM. People record how they feel physically and mentally, and how much they can do in terms of loss of function and independence. howRu is quick and easy to use in routine clinical care; it can deliver prompt feedback to patients and service users, clinicians, managers and commissioners to track changes and identify unexpected variance.

The name stems from the core question “How are you today?”. Today means the previous 24 hours, to cover people with conditions that changes with the time of day or are worse at night.
The howRu questionnaire has four items:

  1. Pain or discomfort (discomfort) covers physical symptoms 
  2. Feeling low or worried (distress) covers emotional symptoms 
  3. Limited in what you can do (disability) covers ability to take part in work, home and leisure activities 
  4. Require help from others (dependence) covers need for support in activities of daily living.

The severity of each howRu item is rated using four levels: None,  A little, Quite a lot, and Extreme.
The results can be entered into electronic medical records as patient-reported history using Read, SNOMED CT or LOINC codes. 

howRu can assist communication and mutual understanding between patients and clinicians.  Feedback can detect unexpected change, prompting remedial action before problems escalate.   Patients, clinicians and managers can track their progress, whether recovering from illness or treatment or coping 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.

Benson T, Potts H, Whatling J, Patterson D. Comparison of howRu and EQ-5D measures of health-related quality of life in an outpatient clinic. Informatics in Primary Care 2013; 21 (1) 12-17.

Benson T, Williams DH, Potts HWW. Performance of EQ-5D, howRu and Oxford hip & knee scores in assessing the outcome of hip and knee replacements. BMC Health Services Research 2016; 16:512