COSMIN database

A systematic review of head and neck cancer quality of life assessment instruments

Ojo, B., Genden, E. M., Teng, M. S., Milbury, K., Misiukiewicz, K. J., and Badr, H.
Although quality of life (QOL) is an important treatment outcome in head and neck cancer (HNC), cross-study comparisons have been hampered by the heterogeneity of measures used and the fact that reviews of HNC QOL instruments have not been comprehensive to date. We performed a systematic review of the published literature on HNC QOL instruments from 1990 to 2010, categorized, and reviewed the properties of the instruments using international guidelines as reference. Of the 2766 articles retrieved, 710 met the inclusion criteria and used 57 different head and neck-specific instruments to assess QOL. A review of the properties of these utilized measures and identification of areas in need of further research is presented. Given the volume and heterogeneity of QOL measures, there is no gold standard questionnaire. Therefore, when selecting instruments, researchers should consider not only psychometric properties but also research objectives, study design, and the pitfalls and benefits of combining different measures. Although great strides have been made in the assessment of QOL in HNC and researchers now have a plethora of quality instruments to choose from, more work is needed to improve the clinical utility of these measures in order to link QOL research to clinical practice. This review provides a platform for head and neck-specific instrument comparisons, with suggestions of important factors to consider in the systematic selection of QOL instruments, and is a first step towards translation of QOL assessment into the clinical scene.
Oral Oncol
1879-0593 (Electronic)
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
General health perceptions / HRQoL:
Health-related quality of life
Overall quality of life:
Overall quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Neoplasms and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
AQLQ - Auckland Quality-of-life Questionnaire
EORTC QLQ-H&N35 - European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Head & Neck 35
FACT-H&N - Functional Assessment of Cancer Therapy-Head and Neck
FACT-NP - Functional Assessment of Cancer Therapy-Nasopharyngeal
FSCI - Facial Skin Cancer Index
FSH&N-SR - Functional Status in Head and Neck cancer – Self Report measure
HNCI - Head and Neck Cancer Inventory
HNQOL - University of Michigan Head and Neck Quality of Life Questionnaire
HNRT-Q - Head and Neck Radiotherapy Questionnaire
H&NS - Head and Neck Survey
LQLQ - University of Liverpool Quality of Life Questionnaire
MCPLQ - Mayo Clinic Post Laryngectomy Questionnaire
MDASI-HN - MD Anderson Symptom Inventory – Head and Neck
NDII - Neck Dissection Impairment Index
NDI - Neck Disability Index    
NDQ - Neck Dissection Quality of life Questionnaire
Parotidectomy QOL Survey - Parotidectomy Quality Of Life Survey
POS-HN - Patient Outcomes of Surgery – Head/Neck [alias: POS H/N]
QLQ-Rathmell - Quality of life Questionnaire-Rathmell
QLQ-Thyroid - Quality of life Questionnaire-Thyroid
QOL-ACD - Quality of Life Questionnaire for Cancer Patients treated with AntiCancer Drugs
QOL-EF - Quality Of Life instrument for patients with Enteral Feeding tubes
QOL-NPC - Quality of Life for Nasopharyngeal Carcinoma
QOL-RTI-H&N - Quality of Life Radiation Therapy Instrument-Head and Neck (QOL-RTI - Quality of Life Radiation Therapy Index)
SDQ - Shoulder Disability Questionnaire [alias: SDQ-NL or SDQ-UK]   
SNOT-22 - Sinonasal Outcome Test-22
SPADI - Shoulder Pain and Disability Index   
University of Frankfurt QLQ - University of Frankfurt Quality of Life Questionnaire
UWQOL (Also: UWQOL-V4)- University of Washington Quality-of-life Instrument (also version 4)
VHNSS - Vanderbilt Head and Neck Symptom Survey