QOL-GEN derives from the sum of all domains, but QOL-MDSS. QOL-ALL = QOL-GEN + QOL-MDSS. A treatment-outcome-index domain (QOL-TOI) derives from the sum of QOL-FIS, QOL-FUN and QOL-MDSS9.
QOL-E V.2 is scored using a standardized scale. The possible range of scores is 0 to 100. A higher score indicates better health for that domain.

Methods: Scoring of the QOL-E instrument

The QOL-E instrument has adopted the HNQoL instrument scoring system10. Each item is re-scaled so that better health corresponds with higher numerical value.
Scales are scored if the patient answers at least half of the items in a multi-item scale11. If a patient answers only 2 out of 4 questions for the physical domain, he or she would have a missing score. If a patient answers 4 out of 7 questions for fatigue, he or she will have a score for the fatigue domain.

After the items are re-scaled, raw scores can be generated for each scale by summing the responses for all items in that scale. No question is weighted more heavily than another: the re-scaled item scores are simply added to generate a raw score.
Transformation of raw scores into a 0-100 scale is performed to generate the standardized score according to the following formula:
Standardized Score = [(actual raw score - lowest possible raw score)/possible raw score range] x 100
Since the general health questions are based on one question each, the scoring algorithm differs as follows: [(raw score-1)/4] X 100.

Extended study results

The translated English version of the questionnaire was tested in 14 patients in the USA and the Bulgarian version was tested in Sofia. These translated versions demonstrated good internal consistency in all dimensions (data not shown).