Professional Documents
Culture Documents
1
Health-Related Quality of Life (HRQOL)
In its 1946 Constitution, the World Health Organization defined health as a state of
complete physical, mental, and social well-being and not merely the absence of disease or
infirmity (1). This definition of health was a departure from the old notion that health
pertained only to death and disease, and it paved the way for later exploration of health-
related quality of life. Ware, developer of the most widely used health-related quality of
life instrument (SF-36), emphasizes that health has dimensionalityphysical health,
mental health, everyday functioning in social and in role activities, and general
perceptions of well-beingand can range from the negative states of disease to more
positive states of well-being (2). The terms quality of life, and more specifically,
health-related quality of life, (HRQOL) are used to refer to the physical,
psychological, and social domains of health, seen as distinct areas that are influenced by a
persons experiences, beliefs, expectations, and perceptions (3). HRQOL reflects an
individuals subjective evaluation and reaction to health or illness (4).
2
Since the time of the initial development of the IWQOL, interest in the quality of life of
obese persons has grown considerably. In June of 1999 the North American Association
for the Study of Obesity convened a task force--Task Force on Developing Obesity
Outcomes and Learning Tools (TOOLS)--whose charge was to choose outcome measures
to be used by obesity clinicians and researchers (19). The task force recommended the
use of the IWQOL-Lite (a short-form of the IWQOL that will be described in detail later)
in clinical practice and in research studies on obesity.
3
use of the IWQOL long form. If you have used the long form in your data collection,
you may still score it using IWQOL-Lite scoring criteria. See the section on scoring
the IWQOL-Lite.
We analyzed baseline IWQOL data from 1,987 subjects who had taken the IWQOL in a
variety of settings an open label study of phentermine-fenfluramine, an intensive day-
treatment program, an outpatient weight loss treatment program, gastric bypass surgery,
and community volunteers. The sample was randomly divided into two groups: a
Development Sample (N = 996) and a Cross-Validation Sample (N=991). The
Development Sample and the Cross-Validation Sample were not statistically different
from each other in terms of BMI, age, gender, or race (p>.25). The Development Sample
provided data upon which decisions about item selection and scale construction were
based. Selection of items and construction of scales in the Development Sample was
accomplished by compiling data on each of the 74 original IWQOL items. Data included
frequency distributions, inter-item correlations, alpha coefficients for scales and total
score, item-to-scale correlations for scales and total score, baseline correlations with
collateral measures, exploratory factor analysis, and 1-year change correlations between
items and collateral measures. Items were selected if they adequately distributed across
item responses (never true to always true), maximized alpha coefficients, maximized
item-to-scale correlations, and correlated significantly with relevant collateral measures,
both cross-sectionally and longitudinally. Initially, we deleted items from the original 74
if they (1) correlated poorly with the scale score, (2) correlated poorly with the total
score, or (3) correlated poorly with BMI. Changes in items at one-year follow-up were
then correlated with changes in BMI at one-year follow-up. Additional items were
deleted if they did not correlate well with changes in BMI. Exploratory factor analyses
were then performed on the reduced set of items. Factor loadings were examined, and
additional items were deleted if they did not load adequately on the derived factors. This
process was repeated iteratively until an acceptable and interpretable factor structure was
obtained. Therefore, assignment of items to scales was based both on exploratory factor
analysis and on the original scale composition. All decisions about item selection were
finalized prior to analyzing any data in the Cross-Validation Sample.
4
A series of confirmatory factor analyses was performed on the Cross-Validation Sample
to evaluate the hypothesized scale structure using EQS software.
The sensitivity of the IWQOL-Lite was evaluated on the Cross-Validation Sample using
two different methods. First, effect sizes were calculated between adjacent BMI groups
(< 25 vs. 25-29.9, 25.9-29.9 vs. 30-34.9, 30-34.9 vs. 35-39.9, etc.) and between extreme
BMI groups (<25 vs. 40+). Effect sizes were calculated as the difference between group
means (after adjusting for age and gender) divided by the standard deviation for the entire
sample. For example, the effect size comparing <25 with 40+ would be calculated as the
adjusted mean for <25 minus the adjusted mean for 40+. That quantity is then divided by
the standard deviation for the entire group. Next, effect sizes were calculated in the one
year longitudinal sample (N = 160) for 3 groups: (1) those subjects losing less than 10%
of baseline BMI, (2) those subjects losing 10-20% of their baseline BMI, and (3) those
subjects losing more than 20% of their baseline BMI. Effect sizes were calculated as the
difference between IWQOL-Lite scores at baseline and 1 year (after adjusting for age and
gender) divided by the standard deviation at baseline (32). Effect sizes were calculated
instead of Guyatts responsiveness statistic because there were not sufficient cases with
stable weight over the one-year period (97% lost at least 10 pounds and 89% lost at least
20 pounds, leaving only five subjects who lost less than ten pounds.)
5
Meaningful Change in IWQOL-Lite Scores
Meaningful changes in IWQOL-Lite total score are determined using the algorithm
described by Crosby and colleagues (21, 22). Based on this algorithm, patients IWQOL-
Lite total scores are considered to have shown meaningful improvement from baseline to
one year if they increased between 7 and 12 points, depending upon baseline severity in
comparison to the normative mean. Normative means for the IWQOL-Lite have been
derived from a sample of 534 non-obese individuals who were not enrolled in any weight
loss treatment program [238 women and 296 men with BMIs between 18.5 and 29.9]
(21).
Afrikaans for South Africa, Arabic for UAE (United Arabic Emirates), Arabic for Israel,
Bengali for India, Bulgarian for Bulgaria, Catalan for Spain, Chinese for Hong Kong,
Chinese for Taiwan, Cebuano for Philippines, Chinese for Hong Kong, Chinese for
Taiwan, Czech for Czech Republic, Danish for Denmark, Dutch for Netherlands, Dutch
for Belgium, English for Australia, English for Canada, English for India, English for
Malaysia, English for New Zealand, English for Philippines, English for Singapore,
English for South Africa, English for the UK (including Ireland), English for the US,
Estonian for Estonia, Finnish for Finland, French for France, French for Belgium, French
for Canada, French for Switzerland, German for Germany, German for Austria, German
for Switzerland, Greek for Greece, Gujarati for India, Harmonized Latin American and
U.S. Spanish, Hebrew for Israel, Hindi for India, Hungarian for Hungary, Italian for Italy,
Italian for Switzerland, Japanese for Japan, Kannada for India, Korean for Korea, Latvian
for Latvia, Lithuanian for Lithuania, Malay for Malaysia, Malay for Singapore,
Malayalam for India, Mandarin for Malaysia, Mandarin for Singapore, Marathi for India,
Norwegian for Norway, Polish for Poland, Portuguese for Portugal, Portuguese for
Brazil, Romanian for Romania, Russian for Russia, Russian for Israel, Russian for
Estonia, Russian for Latvia, Russian for Ukraine, Slovakian for Slovakia, Spanish for
Spain, Spanish for Argentina, Spanish for Chile, Spanish for Costa Rica, Spanish for
Mexico, Spanish for Peru, Spanish for Puerto Rico, Spanish for the USA, Swedish for
Sweden, Swedish for Finland, Tagalog for Philippines, Tamil for India, Tamil for
Malaysia, Telugu for India, Thai for Thailand, Turkish for Turkey, Ukrainian for
Ukraine, Urdu for India, Xhosa for South Africa, and Zulu for South Africa.
Ceiling and Floor Effects of the IWQOL-Lite (Based on a sample size of 12,231
(which includes 550 nonobese, 1344 overweight, 3371 with a BMI of 30-34.9, 3109 with
a BMI of 35-39.9, and 3857 with a BMI of 40+)
6
Ceiling Effects
2% of all individuals scored at the ceiling (a score of 100, i.e. no impairment) on the
IWQOL-Lite
For adults with obesity (BMI 30 and above), .5% scored at the ceiling
For adults with a BMI between 30-34.9, .9% scored at the ceiling
For adults with a BMI between 35-39.9, .5% scored at the ceiling
For adults with a BMI 40 and above, .1% scored at the ceiling
For adults with overweight/obesity (BMI 25 and above), 1 % scored at the ceiling
Floor Effects
.1% of all individuals scored at the floor (a score of 0, i.e. the most severe impairment) on
the IWQOL-Lite
For adults with obesity (BMI 30 and above), .1% scored at the floor
For adults with a BMI between 30-34.9, .0% scored at the floor
For adults with a BMI between 35-39.9, .0% scored at the floor
For adults with a BMI 40 and above, .3% scored at the floor
For adults with overweight/obesity (BMI 25 and above), .1% scored at the floor
7
Below are tables describing the psychometric properties of the IWQOL-Lite in
different samples. Tables 2-9 are based on data from over 11,000 subjects.
8
Table 2. Demographic and Weight Characteristics of Samples
General Severely Weight Outpatient Residential Bariatric Psychiatric Obese Obese Obese
Community Obese Loss Weight Weight Surgery With With with
Community Clinical Loss Loss Type 2 BED Hyper-
Trials Program Program Diabetes lipidemia
(n = 711 ) (n = 317) (n = 1635)
(n = 5519) (n = 2250) (n = 209 ) (n = 692 ) (n = 95 )
(n = 736) (n = 850)
Female 401 (56.4) 241 (76.0) 3971 (72.0) 1827 439 (59.6) 1345 (82.3) 112 (53.6) 330 (47.7) 72 (75.8) 505 (59.4)
(n, %) (81.2)
Age 37.6 (12.4) 48.8 (10.9) 47.0 (11.4) 45.4 (11.3) 49.3 (13.6) 42.3 (10.7) 43.1 55.2 (9.3) 45.0 47.2
(mean, (10.7) (12.6) (10.6)
SD)
Caucasian 442 (62.2) 308 (97.2) 4398 (79.7) 1318 674 (91.6) 1242 146 (69.9) 550 (79.5) 94 (98.9) 773 (90.9)
(n, %) (81.7%)1 (90.2)2
BMI 27.4 (6.8) 43.2 (6.3) 36.8 (6.0) 36.5 (6.7) 39.3 (10.0) 47.5 (8.4) 33.8 (8.6) 34.5 (3.8) 42.0 34.3 (4.6)
(mean, (10.3)
SD)
BMI
Group (n
%)
18-24.9 286 (40.2) 0 (0) 4 (0.1) 0 (0) 0 (0) 0 (0) 33 (15.8) 4 (0.6) 0 (0) 0 (0)
25-29.9 248 (34.9) 0 (0) 402 (7.3) 272 (12.1) 99 (13.5) 0 (0) 38 (18.2) 96 (13.9) 8 (8.4) 152 (17.9)
30-34.9 104 (14.6) 7 (2.2) 2009 (36.4) 804 (35.7) 190 (25.8) 21 (1.3) 61 (29.2) 257 (37.1) 13 (13.7) 355 (41.8)
35-39.9 45 (6.3%) 93 (29.3) 1824 (33.0) 634 (28.2) 159 (21.6) 216 (13.2) 35 (16.7) 297 (42.9) 19 (20.0) 266 (31.3)
40+ 28 (3.9) 217 (68.5) 1280 (23.2) 539 (24.0) 288 (39.1) 1398 (85.5) 42 (20.1) 38 (5.5) 55 (57.9) 77 (9.1)
1 2
of 1613 reporting ethnicity of 1377 reporting ethnicity
9
Table 3. IWQOL-Lite Correlations with BMI for Different Samples
IWQOL- General Severely Weight Outpatient Residential Bariatric Psychiatric Obese Obese Obese
Lite Scale Community Obese Loss Weight Weight Surgery With With with
Community Clinical Loss Loss Type 2 BED Hyperlipidemia
Trials Program Program Diabetes
(n = 711 ) (n = 317) (n = 1635)
(n = (n = 2250) (n = 209 ) (n = 692 ) (n = 95 ) (n = 850)
5519) (n = 736)
Physical -.605*** -.440*** -.402*** -.422*** -.570*** -.252*** -.617*** -.313*** -.498*** -.339***
Function
Self- -.315*** -.127* -.190*** -.179*** -293*** .048 -.540*** -.278*** -.164 -.191***
Esteem
Sexual -.242*** -.116* -.130*** -.166*** -.204*** -.034 -.390*** -.153*** -.133 -.150***
Life
Public -.460*** -.506*** -.571*** -.548*** -.699*** -.382*** -.593*** -.351*** -.643*** -.519***
Distress
Work -.413*** -.240*** -.220*** -.304*** -.266*** -.195*** -.563*** -.211*** -.251* -.225***
Total -.534*** -.376*** -.389*** -.409*** -.569*** -.215*** -.649*** -.337*** -.469*** -.349***
Score
10
Table 4.Means and Standard Deviations of IWQOL-Lite Scores for Different Samples
IWQOL- General Severely Weight Outpatient Residential Bariatric Psychiatric Obese Obese Obese
Lite Scale Community Obese Loss Weight Weight Surgery With With with
Community Clinical Loss Loss Type 2 BED Hyperlipidemia
Trials Program Program Diabetes
(n = 711 ) (n = 317) (n = (n = 1635)
5519) (n = 2250) (n = 209 ) (n = 692 ) (n = 95 ) (n = 850)
(n = 736)
Physical 90.0 (14.9) 48.4 (21.2) 68.9 65.1 (22.2) 57.3 (26.4) 31.7 62.6 72.1 (20.1) 49.7 73.2 (19.0)
Function (20.6) (21.7) (27.5) (28.2)
Self- 87.5 (19.4) 45.9 (25.9) 59.1 56.1 (27.7) 57.7 (27.2) 30.4 57.2 72.0 (24.7) 39.3 63.6 (26.0)
Esteem (26.4) (25.3) (31.4) (25.9)
Sexual 95.1 (13.0) 65.9 (29.9) 75.1 70.9 (28.0) 65.8 (28.2) 45.8 66.7 80.5 (23.6) 59.1 79.1 (24.5)
Life (26.0) (31.8) (34.6) (30.4)
Public 96.5 (10.9) 62.0 (24.7) 83.5 78.9 (23.6) 71.8 (26.7) 40.8 75.5 89.1 (16.1) 59.2 88.8 (15.7)
Distress (20.2) (25.4) (27.4) (28.4)
Work 95.4 (11.5) 68.1 (23.7) 84.0 79.7 (21.9) 72.0 (23.5) 49.7 72.2 85.6 (18.0) 60.8 85.4 (17.3)
(18.4) (27.5) (28.9) (28.9)
Total 91.8 (12.0) 54.6 (19.5) 71.8 67.9 (19.6) 62.6 (20.7) 36.9 65.3 77.6 (16.8) 51.5 75.9 (16.3)
Score (17.8) (19.0) (25.2) (21.9)
11
Table 5. Means and Standard Deviations of IWQOL-Lite Scores by BMI and Gender
for Total Sample (n = 11,640)
BMI
IWQOL scale Sex 18.0-24.9 2529.9 3034.9 3539.9 40+
94.8 (7.3) 82.0 (15.0) 71.8 (19.1) 61.9 (22.0) 43.9 (24.6)
Females n = 241 n = 758 n = 2338 n = 2212 n = 2924
Physical 93.8 (11.0) 88.8 (11.0) 78.1 (17.4) 67.6 (20.6) 46.2 (25.7)
Males
Function n = 97 n = 441 n = 945 n = 810 n = 870
94.5 (8.5) 84.4 (14.1) 73.6 (18.8) 63.4 (21.8) 44.5 (24.9)
Total
n = 338 n = 1199 n = 3283 n = 3022 n = 3794
85.5 (20.1) 65.0 (26.0) 55.4 (26.4) 49.3 (26.7) 40.1 (27.2)
Females
n = 241 n = 758 n = 2338 n = 2213 n = 2924
95.0 (12.6) 87.9 (16.1) 77.4 (20.7) 68.3 (24.0) 53.1 (27.4)
Self-Esteem Males
n = 97) n = 440 n = 944 n = 809 n = 870
88.2 (18.8) 73.4 (25.4) 61.8 (26.8) 54.4 (27.3) 43.1 (27.8)
Total
n = 338 n = 1198 n = 3282 n = 3022 n = 3794
94.5 (14.4) 78.6 (24.8) 71.3 (27.3) 67.3 (28.6) 57.6 (32.6)
Females
n = 237 n = 735 n = 2250 n = 2134 n = 2750
97.7 (10.9) 94.3 (13.0) 86.3 (19.3) 80.5 (22.9) 66.1 (29.6)
Sexual Life Males
n = 97 n = 439 n = 939 n = 807 n = 849
95.4 (13.5) 84.5 (22.5) 75.7 (26.1) 70.9 (27.8) 59.6 (32.1)
Total
n = 334 n = 1174 n = 3189 n = 2941 n = 3599
97.8 (8.1) 94.9 (10.2) 89.3 (15.0) 78.2 (21.2) 51.9 (27.9)
Females
n = 241 n = 758 n = 2338 n = 2211 n = 2925
97.3 (10.9) 97.3 (6.8) 93.2 (11.1) 84.5 (17.5) 55.7 (27.4)
Public Distress Males
n = 97 n = 441 n = 944 n = 810 n = 870
97.7 (9.0) 95.8 (9.2) 90.4 (14.1) 79.9 (20.4) 52.8 (27.8)
Total
n = 338 n = 1199 n = 3282 n = 3021 n = 3795
97.6 (8.3) 89.1 (16.3) 84.2 (18.8) 77.6 (22.4) 63.7 (28.4)
Females
n = 234 n = 747 n = 2322 n = 2182 n = 2877
96.7 (9.9) 93.3 (12.6) 88.5 (15.1) 83.4 (18.5) 67.7 (26.3)
Work Males
n = 94 n = 436 n = 934 n = 798 n = 854
97.4 (8.7) 90.7 (15.2) 85.4 (17.9) 79.1 (21.6) 64.6 (28.0)
Total
n = 328 n = 1183 n = 3256 n = 2980 n = 3731
93.5 (8.8) 80.7 (13.8) 72.5 (16.6) 64.4 (19.1) 48.5 (22.3)
Females
n = 241 n = 758 n = 2339 n = 2213 n = 2925
95.5 (10.0) 91.3 (9.1) 82.8 (13.4) 74.2 (16.4) 54.6 (22.1)
IWQOL-Lite Total Males
n = 97 n = 441 n = 945 n = 810 n = 870
94.0 (9.2) 84.6 (13.3) 75.4 (16.5) 67.0 (18.9) 49.9 (22.4)
Total
n = 338 n = 1199 n = 3284 n = 3023 n = 3795
12
Table 6. Means and Standard Deviations of IWQOL-Lite Scores by Age and Gender
for Obese Sample (BMI > 30) (n = 10,096)
Age Group
IWQOL 18.0-24.9 2534.9 3544.9 4554.9 55-64.9 65+
Sex
scale
65.9 (24.8) 60.3 (24.9) 59.1 (25.1) 56.4 (24.8) 55.1 (26.0) 56.2 (24.4)
Females
n = 303 n = 1245 n = 2068 n = 2322 n = 1232 n = 301
Physical 73.6 (21.3) 69.2 (23.0) 63.9 (25.4) 62.4 (26.2) 62.5 (25.1) 69.1 (23.5)
Males
Function n = 50 n = 294 n = 615 n = 852 n = 630 n = 181
67.0 (24.5) 62.0 (24.8) 60.2 (25.2) 58.0 (25.3) 57.6 (25.9) 61.1 (24.8)
Total
n = 353 n = 1539 n = 2683 n = 3174 n = 1862 n = 482
44.6 (27.4) 40.1 (27.1) 44.6 (27.3) 49.7 (26.6) 54.0 (27.8) 60.4 (25.4)
Females
n = 302 n = 1245 n = 2070 n = 2321 n = 1233 n = 301
Self- 57.5 (26.8) 60.3 (28.1) 61.6 (26.2) 65.9 (26.1) 71.7 (24.2) 80.6 (20.2)
Males
Esteem n = 49 n = 293 n = 615 n = 852 n = 630 n = 181
46.4 (27.6) 44.0 (28.4) 48.5 (28.0) 54.0 (27.4) 60.0 (27.9) 70.0 (25.5)
Total
n = 351 n = 1538 n = 2685 n = 3173 n = 1863 n = 482
73.3 (27.6) 64.0 (30.3) 64.3 (29.5) 64.6 (30.5) 64.1 (31.9) 67.9 (31.0)
Females
n = 291 n = 1212 n = 2022 n = 2230 n = 1123 n = 253
Sexual 84.3 (24.9) 80.8 (24.8) 79.7 (25.7) 77.2 (25.3) 75.1 (26.2) 77.7 (25.4)
Males
Life n = 47 n = 294 n = 609 n = 843 n = 621 n = 178
74.8 (27.4) 67.3 (30.1) 67.9 (29.4) 68.1 (29.7) 68.0 (30.5) 72.0 (29.2)
Total
n = 338 n = 1506 n = 2631 n = 3073 n = 1744 n = 431
68.6 (28.6) 64.8 (29.3) 69.3 (28.2) 73.1 (26.7) 76.7 (26.3) 81.1 (22.1)
Females
n = 303 n = 1245 n = 2069 n = 2321 n = 1232 n = 301
Public 77.0 (24.6) 73.8 (26.8) 74.0 (27.9) 77.2 (25.9) 82.2 (22.2) 89.3 (17.1)
Males
Distress n = 50 n = 293 n = 615 n = 852 n = 630 n = 181
69.8 (28.2) 66.5 (29.0) 70.3 (28.2) 74.2 (26.5) 78.5 (25.1) 84.2 (20.7)
Total
n = 353 n = 1538 n = 2684 n = 3173 n = 1862 n = 482
77.4 (26.4) 72.9 (26.4) 73.5 (26.0) 75.1 (24.9) 74.6 (25.4) 74.3 (22.2)
Females
n = 300 n = 1230 n = 2050 n = 2294 n = 1212 n = 292
81.4 (19.5) 79.1 (22.9) 78.2 (24.9) 79.2 (22.8) 81.7 (19.5) 85.5 (17.4)
Work Males
n = 50 n = 292 n = 606 n = 844 n = 616 n = 175
77.9 (25.5) 74.1 (25.9) 74.6 (25.8) 76.2 (24.4) 77.0 (23.9) 78.5 (21.2)
Total
n = 350 n = 1522 n = 2656 n = 3138 n = 1828 n = 467
63.9 (21.9) 58.5 (22.4) 60.0 (22.4) 61.0 (21.9) 61.9 (22.8) 64.7 (19.9)
Females
n = 303 n = 1245 n = 2070 n = 2323 n = 1233 n = 300
IWQOL- 73.0 (16.4) 70.7 (21.4) 68.8 (22.3) 69.6 (21.8) 71.8 (20.4) 78.2 (17.1)
Males
Lite Total n = 50 n = 294 n = 615 n = 852 n = 630 n = 181
65.2 (21.4) 60.8 (22.7) 62.0 (22.6) 63.3 (22.2) 65.3 (22.5) 70.0 (20.0)
Total
n = 353 n = 1539 n = 2685 n = 3175 n = 1863 n = 481
13
Table 7. Cut-offs for none, mild, moderate, severe baseline IWQOL-Lite total
score*
14
Table 8. Item to Scale Correlations Total Sample (n = 11,640)
Physical Self- Sexual Public
Physical Function
Self-Esteem
could be
15
Sexual Life
activity
performance
Public Distress
Worry about finding chairs -.668 -.512 -.461 -.847 -.600 -.722
Work
things
16
Table 9. Internal Consistency of IWQOL-Lite Scores for Different Samples
IWQOL- General Severely Weight Outpatient Residential Bariatric Psychiatric Obese Obese Obese Total
Lite Community Obese Loss Weight Weight Surgery With With with
Scale Community Clinical Loss Loss Type 2 BED Hyper-
Trials Program Program Diabetes lipidemia
(n = 711 ) (n = 317) (n = (n =
5519) (n = 2250) 1635) (n = 209 ) (n = 692 ) (n = 95
(n = 736) ) (n = 850) (n =
11,640)
Physical .920 .908 .908 .906 .935 .908 .939 .910 .945 .893 .940
Function
Self- .938 .935 .927 .928 .922 .920 .945 .932 .912 .926 .940
Esteem
Sexual .910 .939 .926 .923 .890 .927 .932 .909 .893 .925 .935
Life
Public .893 .881 .889 .888 .893 .861 .913 .872 .875 .844 .919
Distress
Work .831 .795 .789 .836 .882 .800 .892 .781 .913 .770 .860
Total .953 .949 .951 .952 .953 .941 .973 .953 .955 .945 .967
Score
17
Table 10a. Percentiles Associated with IWQOL-Lite Scores for Obese Female
Sample (BMI > 30) (n = 7,478)
18
42 54.545 39.286 62.500 70.000 75.000 58.065
43 54.545 42.857 62.500 70.000 75.000 58.871
44 56.818 42.857 62.500 75.000 75.000 59.677
45 56.818 42.857 62.500 75.000 75.000 60.484
46 56.818 42.857 68.750 75.000 75.000 60.484
47 59.091 46.429 68.750 75.000 75.000 61.290
48 59.091 46.429 68.750 75.000 81.250 62.097
49 59.091 46.429 68.750 75.000 81.250 62.903
50 61.364 46.429 68.750 80.000 81.250 62.903
51 61.364 46.429 68.750 80.000 81.250 63.710
52 61.364 50.000 68.750 80.000 81.250 64.516
53 63.636 50.000 75.000 80.000 81.250 64.516
54 63.636 50.000 75.000 80.000 81.250 65.323
55 63.636 50.000 75.000 85.000 87.500 66.129
56 65.909 53.571 75.000 85.000 87.500 66.935
57 65.909 53.571 75.000 85.000 87.500 67.742
58 65.909 53.571 75.000 85.000 87.500 67.742
59 65.909 53.571 75.000 85.000 87.500 68.548
60 68.182 53.571 75.000 85.000 87.500 69.355
61 68.182 57.143 75.000 90.000 87.500 70.161
62 68.182 57.143 81.250 90.000 87.500 70.161
63 70.455 57.143 81.250 90.000 87.500 70.968
64 70.455 57.143 81.250 90.000 87.500 71.774
65 70.455 60.714 81.250 90.000 93.750 72.581
66 72.727 60.714 81.250 90.000 93.750 72.581
67 72.727 60.714 87.500 90.000 93.750 73.387
68 72.727 64.286 87.500 90.000 93.750 73.387
69 75.000 64.286 87.500 95.000 93.750 74.194
70 75.000 64.286 87.500 95.000 93.750 75.000
71 75.000 64.286 87.500 95.000 93.750 75.806
72 75.000 64.286 87.500 95.000 93.750 75.935
73 77.273 67.857 93.750 95.000 93.750 76.613
74 77.273 67.857 93.750 95.000 100.000 77.419
75 79.545 67.857 93.750 95.000 100.000 78.226
76 79.545 71.429 93.750 95.000 100.000 79.032
77 79.545 71.429 93.750 100.000 100.000 79.839
78 81.818 71.429 100.000 100.000 100.000 79.839
79 81.818 71.429 100.000 100.000 100.000 80.645
80 81.818 75.000 100.000 100.000 100.000 81.452
81 81.818 75.000 100.000 100.000 100.000 82.258
82 84.091 75.000 100.000 100.000 100.000 82.258
83 84.091 78.571 100.000 100.000 100.000 83.065
84 84.091 78.571 100.000 100.000 100.000 83.871
85 86.364 78.571 100.000 100.000 100.000 84.677
86 86.364 82.143 100.000 100.000 100.000 85.484
87 86.364 82.143 100.000 100.000 100.000 86.290
88 88.636 82.143 100.000 100.000 100.000 87.097
89 88.636 85.714 100.000 100.000 100.000 87.903
90 88.636 85.714 100.000 100.000 100.000 88.710
91 90.909 85.714 100.000 100.000 100.000 89.516
19
92 90.909 89.286 100.000 100.000 100.000 90.323
93 90.909 89.286 100.000 100.000 100.000 91.129
94 93.182 92.857 100.000 100.000 100.000 91.935
95 93.182 92.857 100.000 100.000 100.000 92.742
96 95.455 96.429 100.000 100.000 100.000 93.548
97 95.455 96.429 100.000 100.000 100.000 95.161
98 97.727 100.000 100.000 100.000 100.000 95.968
99 100.000 100.000 100.000 100.000 100.000 97.581
20
Table 10b. Percentiles Associated with IWQOL-Lite Scores for Obese Male Sample
(BMI > 30) (n = 2,625)
21
45 65.909 67.857 81.250 85.000 81.250 72.581
46 65.909 67.857 81.250 85.000 87.500 73.387
47 65.909 67.857 87.500 85.000 87.500 74.194
48 68.182 67.857 87.500 85.000 87.500 74.194
49 68.182 71.429 87.500 90.000 87.500 75.000
50 70.455 71.429 87.500 90.000 87.500 75.000
51 70.455 71.429 87.500 90.000 87.500 75.806
52 70.455 71.429 87.500 90.000 87.500 76.613
53 72.727 71.429 87.500 90.000 87.500 77.242
54 72.727 75.000 87.500 90.000 87.500 77.419
55 72.727 75.000 87.500 90.000 87.500 78.226
56 75.000 75.000 93.750 90.000 87.500 78.226
57 75.000 75.000 93.750 90.000 87.500 79.032
58 75.000 75.000 93.750 95.000 93.750 79.839
59 75.000 75.000 93.750 95.000 93.750 80.645
60 75.000 78.571 93.750 95.000 93.750 80.645
61 77.273 78.571 93.750 95.000 93.750 81.452
62 77.273 78.571 93.750 95.000 93.750 81.452
63 77.273 78.571 93.750 95.000 93.750 82.258
64 78.727 78.571 93.750 95.000 93.750 83.065
65 79.545 82.143 100.000 95.000 93.750 83.065
66 79.545 82.143 100.000 95.000 93.750 83.871
67 79.545 82.143 100.000 95.000 93.750 83.871
68 81.818 82.143 100.000 95.000 93.750 84.677
69 81.818 85.714 100.000 96.250 100.000 85.484
70 81.818 85.714 100.000 100.000 100.000 85.484
71 81.818 85.714 100.000 100.000 100.000 86.290
72 84.091 85.714 100.000 100.000 100.000 86.290
73 84.091 85.714 100.000 100.000 100.000 87.097
74 84.091 85.714 100.000 100.000 100.000 87.097
75 84.091 89.286 100.000 100.000 100.000 87.097
76 86.364 89.286 100.000 100.000 100.000 87.903
77 86.364 89.286 100.000 100.000 100.000 88.710
78 86.364 89.286 100.000 100.000 100.000 88.710
79 86.364 92.714 100.000 100.000 100.000 89.516
80 86.364 92.857 100.000 100.000 100.000 89.516
81 88.636 92.857 100.000 100.000 100.000 90.323
82 88.636 92.857 100.000 100.000 100.000 91.129
83 88.636 92.857 100.000 100.000 100.000 91.129
84 88.636 92.857 100.000 100.000 100.000 91.935
85 90.909 96.429 100.000 100.000 100.000 91.935
86 90.909 96.429 100.000 100.000 100.000 92.742
87 90.909 96.429 100.000 100.000 100.000 92.742
88 90.909 96.429 100.000 100.000 100.000 93.548
89 93.182 96.429 100.000 100.000 100.000 94.355
90 93.182 100.000 100.000 100.000 100.000 94.355
91 93.182 100.000 100.000 100.000 100.000 95.161
92 95.455 100.000 100.000 100.000 100.000 95.161
93 95.455 100.000 100.000 100.000 100.000 95.968
94 95.455 100.000 100.000 100.000 100.000 95.968
22
95 95.455 100.000 100.000 100.000 100.000 96.774
96 97.727 100.000 100.000 100.000 100.000 97.581
97 97.727 100.000 100.000 100.000 100.000 98.387
98 100.000 100.000 100.000 100.000 100.000 98.387
99 100.000 100.000 100.000 100.000 100.000 100.000
23
Table 11: Conversion of Raw Scores to Transformed (0-100) Scores
Raw Physical Self- Sexual Public Work Total
Score Function Esteem Life Distress Score
4 100 100
5 93.8 100 93.8
6 87.5 95.0 87.5
7 100 81.3 90.0 81.3
8 96.4 75.0 85.0 75.0
9 92.9 68.8 80.0 68.8
10 89.3 62.5 75.0 62.5
11 100 85.7 56.3 70.0 56.3
12 97.7 82.1 50.0 65.0 50.0
13 95.5 78.6 43.8 60.0 43.8
14 93.2 75.0 37.5 55.0 37.5
15 90.9 71.4 31.3 50.0 31.3
16 88.6 67.9 25.0 45.0 25.0
17 86.4 64.3 18.8 40.0 18.8
18 84.1 60.7 12.5 35.0 12.5
19 81.8 57.1 6.3 30.0 6.3
20 79.5 53.6 0 25.0 0
21 77.3 50.0 20.0
22 75.0 46.4 15.0
23 72.7 42.9 10.0
24 70.5 39.3 5.0
25 68.2 35.7 0
26 65.9 32.1
27 63.6 28.6
28 61.4 25.0
29 59.1 21.4
30 56.8 17.9
31 54.5 14.3 100
32 52.3 10.7 99.2
33 50.0 7.1 98.4
34 47.7 3.6 97.6
35 45.5 0 96.8
36 43.2 96.0
37 40.9 95.2
38 38.6 94.4
39 36.4 93.5
40 34.1 92.7
41 31.8 91.9
42 29.5 91.1
43 27.3 90.3
44 25.0 89.5
45 22.7 88.7
46 20.5 87.9
47 18.2 87.1
48 15.9 86.3
49 13.6 85.5
24
50 11.4 84.7
51 9.1 83.9
52 6.8 83.1
53 4.5 82.3
54 2.3 81.5
55 0 80.6
56 79.8
57 79.0
58 78.2
59 77.4
60 76.6
61 75.8
62 75.0
63 74.2
64 73.4
65 72.6
66 71.8
67 71.0
68 70.2
69 69.4
70 68.5
71 67.7
72 66.9
73 66.1
74 65.3
75 64.5
76 63.7
77 62.9
78 62.1
79 61.3
80 60.5
81 59.7
82 58.9
83 58.1
84 57.3
85 56.5
86 55.6
87 54.8
88 54.0
89 53.2
90 52.4
91 51.6
92 50.8
93 50.0
94 49.2
95 48.4
96 47.6
97 46.8
98 46.0
25
99 45.2
100 44.4
101 43.5
102 42.7
103 41.9
104 41.1
105 40.3
106 39.5
107 38.7
108 37.9
109 37.1
110 36.3
111 35.5
112 34.7
113 33.9
114 33.1
115 32.3
116 31.5
117 30.6
118 29.8
119 29.0
120 28.2
121 27.4
122 26.6
123 25.8
124 25.0
125 24.2
126 23.4
127 22.6
128 21.8
129 21.0
130 20.2
131 19.4
132 18.5
133 17.7
134 16.9
135 16.1
136 15.3
137 14.5
138 13.7
139 12.9
140 12.1
141 11.3
142 10.5
143 9.7
144 8.9
145 8.1
146 7.3
147 6.5
26
148 5.6
149 4.8
150 4.0
151 3.2
152 2.4
153 1.6
154 0.8
155 0
27
Table 12: IWQOL-Lite Six-Month Change Scores for Men
Weight Loss Group Physical Self- Sexual Public Work IWQOL-
Function Esteem Life Distress Change Lite Total
Change Change Change Change Change
Weight Mean 2.188 3.966 1.046 1.045 -.894 1.930
Gain N 134 134 132 134 132 134
Std. Deviation 12.018 16.342 17.800 10.744 16.830 9.562
Grouped 2.266 3.560 1.364E- .467 2.128E- 2.377
Median 02 03
Minimum -45.5 -57.2 -100.0 -30.0 -62.5 -25.8
Maximum 34.1 64.3 50.0 35.0 50.0 29.0
Range 79.6 121.5 150.0 65.0 112.5 54.8
0-4.9% Mean 6.192 6.783 3.293 2.591 2.967 4.926
Loss N 467 466 464 467 461 467
Std. Deviation 13.257 13.424 16.067 10.969 13.673 9.622
Grouped 4.545 3.596 2.279E- 2.189 2.389E- 4.039
Median 02 02
Minimum -50.0 -53.5 -100.0 -50.0 -56.3 -43.6
Maximum 61.4 67.9 75.0 50.0 56.3 49.2
Range 111.4 121.4 175.0 100.0 112.5 92.8
5-9.9% Mean 9.969 10.548 4.106 4.251 3.704 7.602
Loss N 374 372 369 374 372 374
Std. Deviation 13.984 15.025 15.246 11.698 11.744 10.063
Grouped 9.084 7.161 2.528E- 2.464 3.242E- 6.474
Median 02 02
Minimum -52.3 -32.2 -75.0 -50.0 -37.5 -35.5
Maximum 77.3 92.9 87.5 50.0 43.8 54.8
Range 129.5 125.1 162.5 100.0 81.3 90.3
10- Mean 16.719 12.259 7.329 5.794 5.828 11.308
14.9% N 170 169 169 170 170 170
Loss Std. Deviation 16.107 15.865 17.171 11.946 15.604 11.679
Grouped 13.645 10.706 3.519E- 3.039 4.697E- 9.487
Median 02 02
Minimum -52.3 -39.3 -56.2 -20.0 -62.5 -35.5
Maximum 79.5 67.9 81.3 65.0 56.3 58.9
Range 131.8 107.2 137.5 85.0 118.8 94.3
28
15% Mean 19.745 16.089 9.126 9.148 5.132 13.905
+ N 88 87 87 88 87 88
Loss Std. Deviation 16.139 18.335 14.065 16.050 13.344 11.805
Grouped Median 18.170 13.067 5.523 5.000 3.611E- 11.669
02
Minimum -11.4 -35.8 -18.8 -35.0 -25.0 -12.1
Maximum 61.4 60.7 62.5 60.0 50.0 49.2
Range 72.8 96.5 81.3 95.0 75.0 61.3
All Mean 9.321 9.029 4.270 3.836 3.326 6.933
Men N 1233 1228 1221 1233 1222 1233
Std. Deviation 14.830 15.294 16.159 11.883 13.860 10.705
Grouped Median 6.858 7.143 2.642E- 2.917 2.843E- 5.657
02 02
Minimum -52.3 -57.2 -100.0 -50.0 -62.5 -43.6
Maximum 79.5 92.9 87.5 65.0 56.3 58.9
Range 131.8 150.1 187.5 115.0 118.8 102.4
29
Table 13: IWQOL-Lite Six-Month Change Scores for Women
Weight Gain Mean 2.576 8.208 4.861 2.113 1.955 3.956
N 389 388 376 388 387 389
Std. Deviation 13.975 17.654 19.114 13.388 15.524 11.434
Grouped Median 2.273 7.120 2.885E-02 2.026 1.849E-02 3.226
Minimum -59.3 -46.4 -81.2 -70.0 -56.3 -39.8
Maximum 56.9 64.3 81.3 50.0 62.5 46.0
Range 116.2 110.7 162.5 120.0 118.8 85.9
0-4.9% Loss Mean 8.501 11.778 5.829 4.004 4.572 7.674
N 1092 1086 1045 1089 1087 1092
Std. Deviation 14.177 17.426 21.138 13.227 15.349 11.359
Grouped Median 6.827 10.714 4.411E-02 3.420 3.447E-02 6.452
Minimum -52.3 -75.0 -100.0 -75.0 -75.0 -69.4
Maximum 68.2 92.9 100.0 55.0 75.0 54.8
Range 120.5 167.9 200.0 130.0 150.0 124.2
5-9.9% Loss Mean 12.261 14.405 8.669 5.343 5.510 10.266
N 912 910 864 912 905 912
Std. Deviation 14.107 18.234 20.197 14.001 14.775 11.635
Grouped Median 9.988 14.257 2.165 1.799 4.108E-02 9.095
Minimum -54.5 -57.1 -75.0 -50.0 -50.0 -50.0
Maximum 75.0 85.7 100.0 90.0 87.5 62.1
Range 129.6 142.8 175.0 140.0 137.5 112.1
10-14.9% Loss Mean 16.435 19.167 11.540 6.897 7.715 13.766
N 535 532 505 535 531 534
Std. Deviation 15.217 19.664 19.667 13.578 15.648 12.453
Grouped Median 15.870 17.857 6.263 5.000 2.238 12.619
Minimum -50.0 -57.1 -56.3 -60.0 -62.5 -53.2
Maximum 68.2 100.0 100.0 90.0 62.5 75.8
Range 118.2 157.1 156.3 150.0 125.0 129.1
15% + Loss Mean 18.997 21.162 13.972 8.814 8.391 15.837
N 350 349 331 350 348 350
Std. Deviation 16.209 21.358 21.400 15.153 15.637 13.531
Grouped Median 15.918 21.407 6.291 4.167 .809 13.716
Minimum -25.0 -50.0 -37.5 -30.0 -37.5 -29.8
Maximum 70.4 89.3 100.0 80.0 75.0 63.7
Range 95.4 139.3 137.5 110.0 112.5 93.6
All Women Mean 11.260 14.293 8.286 5.140 5.442 9.819
N 3278 3265 3121 3274 3258 3277
Std. Deviation 15.284 18.906 20.635 13.854 15.397 12.366
Grouped Median 9.091 12.292 4.395 1.928 3.985E-02 8.871
Minimum -59.3 -75.0 -100.0 -75.0 -75.0 -69.4
Maximum 75.0 100.0 100.0 90.0 87.5 75.8
Range 134.4 175.0 200.0 165.0 162.5 145.2
30
Table 14: IWQOL-Lite Six-Month Change Scores for Total Sample
Weight Gain Mean 2.477 7.119 3.869 1.839 1.231 3.437
N 523 522 508 522 519 523
Std. Deviation 13.491 17.411 18.838 12.760 15.898 11.011
Grouped Median 2.273 3.582 2.432E-02 1.643 1.451E-02 2.455
Minimum -59.3 -57.2 -100.0 -70.0 -62.5 -39.8
Maximum 56.9 64.3 81.3 50.0 62.5 46.0
Range 116.2 121.5 181.3 120.0 125.0 85.9
0-4.9% Loss Mean 7.810 10.278 5.049 3.580 4.094 6.851
31
Six-Month Changes in IWQOL-Lite Scores for Weight Loss Participants (n = 4511)
Figures 1-6
32
33
34
35
36
37
IWQOL-Lite Scoring
Raw scores for each scale are computed for each of the five scales only if a minimum of
50% of the items for that scale are answered, and for the total score only if 75% of the
answers for all items are completed. (The required number of minimum responses is:
Physical Function=6 of 11; Self-Esteem =4 of 7; Sexual Life=2 of 4; Public Distress=3 of
5; Work=2 of 4; Total=24 of 31.) In computing raw scores, we use a pro-rated system for
handling missing data. To calculate the raw score for any scale or total score, the
procedures are as follows:
1- Determine if the minimum number of items are answered for that scale. The required
number of minimum responses is: Physical Function=6 of 11; Self-Esteem =4 of 7;
Sexual Life=2 of 4; Public Distress=3 of 5; Work=2 of 4; Total=24 of 31.
Example 2: If an individual answered 26 items on the entire scale, a valid score would be
calculated for the IWQOL-Lite total.
2- Take the average of the valid items for that scale. Compute the average for the valid
responses to items for that scale where 1=Never True and 5=Always True. The
average must be a number between 1 and 5. For example, if the respondent answered 3
on every item of the Physical Function scale, the mean would be 3.
3- Multiply that average by the total number of items for that scale. The total number of
items on IWQOL-Lite scales are as follows: Physical Function=11, Self-Esteem=7,
Sexual Life=4, Public Distress=5, Work=4, Total=31). Round to the nearest whole
integer. For example, if the mean of the Physical Function scale is 3.0, then you would
multiply 3.0 X 11 = 33.
Example 5: From the Physical Function answers in Example 3, multiply the average (3.0)
times the number of total questions in the Physical Function scale (11) and round to the
nearest whole integer: 3 X 11 = 33 (no need to round). This is the Physical Function Raw
Score.
Example 6: From the Public Distress answers in Example 4, multiply the average (2.8)
times the number of total questions in the Public Distress scale (5) and round to the
38
nearest whole integer: 2.8 X 5 = 14 (no need to round). This is the Public Distress Raw
Score.
do if (misstot lt 8).
end if.
Here is the code for calculating the individual scales of the IWQOL-Lite:
do if (misspf lt 6).
end if.
39
count missse = IWSE1 TO IWSE7 (9,missing,sysmis).
do if (missse lt 4).
end if.
do if (misssl lt 3).
end if.
do if (misspd lt 3).
end if.
40
***** Compute WORK Score.
do if (misswk lt 3).
end if.
We have been converting the IWQOL-Lite raw scores to the more familiar 0 (worst) to
100 (best) scoring using the following formulae:
1. Subtract the raw score (as calculated above) from the maximum score for each scale
(Physical Function=55, Self-Esteem=35, Sexual Life=20, Public Distress=25,
Work=20, Total=155).
2. Divide that difference by the range for each scale (Physical Function=44, Self-
Esteem=28, Sexual Life=16, Public Distress=20, Work=16, Total=124).
Example 7: From the Physical Function answers in Example 5, subtract the raw score
(33) from the maximum score for Physical Function (55) and divide that result by the
range for Physical Function (44) and multiply the result by 100: (55 - 33)/44 = .50 X 100
= 50.
Example 8: From the Public Distress answers in Example 6, subtract the raw score (14)
from the maximum score for Public Distress (25) and divide that result by the range for
Public Distress (20) and multiply by 100: (25 - 14)/20 = .55 X 100 = 55.
An easy way to check the scoring is to enter a record with all 1's and a second record with
all 5's. The first record should have all transformed scores equal to 100 and the second
record should have all transformed scores equal to 0.
41
compute iwset = ((35-iwse)/28)*100.
42
How to Convert IWQOL Long form item responses to IWQOL-Lite Scoring
* THIS PROGRAM CONVERTS IWQOL FILES FROM OLD VERSION TO LITE VERSION AND
SCORES LITE VERSION.
RENAME VAR ( mob8,mob6,mob4,mob7,mob2,mob1,mob5,hlth4,hlth10,hlth8,hlth1,
se4,se2,se1,se8,si11,se7,si2,
sex6,sex2,sex4,sex5,
si5,adl7,adl3,adl2,si3,
wrk1,wrk3,wrk4,wrk5
= IWPF1 TO IWPF11
IWSE1 TO IWSE7
IWSEX1 TO IWSEX4
IWPD1 TO IWPD5
IWWRK1 TO IWWRK4).
SAVE OUTFILE='C:\DATA\Kolotkin\Norms\temp.sav'
/COMPRESSED/KEEP = ID SITE
IWPF1 IWPF2 IWPF3 IWPF4 IWPF5 IWPF6 IWPF7 IWPF8 IWPF9 IWPF10 IWPF11
IWSE1 IWSE2 IWSE3 IWSE4 IWSE5 IWSE6 IWSE7
IWSEX1 IWSEX2 IWSEX3 IWSEX4
IWPD1 IWPD2 IWPD3 IWPD4 IWPD5
IWWRK1 IWWRK2 IWWRK3 IWWRK4.
VAR LAB IWPF1 'Trouble picking up objects'/
IWPF2 'Trouble tying shoes'/
IWPF3 'Difficulty getting up from chairs'/
IWPF4 'Trouble using stairs'/
IWPF5 'Difficulty dressing'/
IWPF6 'Trouble with mobility'/
IWPF7 'Trouble crossing legs'/
IWPF8 'Feel short of breath'/
IWPF9 'Painful stiff joints'/
IWPF10 'Ankles & legs swollen'/
IWPF11 'Worried about health'/
IWSE1 'Self-conscious'/
IWSE2 'Self-esteem not what it could be'/
IWSE3 'Feel unsure of self'/
IWSE4 'Do not like myself'/
IWSE5 'Afraid of being rejected'/
IWSE6 'Avoid looking in mirrors'/
IWSE7 'Embarassed in public places'/
IWSEX1 'Do not enjoy sexual activity'/
IWSEX2 'Have little sexual desire'/
IWSEX3 'Difficulty with sexual performance'/
IWSEX4 'Avoid sexual encounters'/
IWPD1 'Experience ridicule & teasing'/
IWPD2 'Worry about fitting in public seats'/
IWPD3 'Worry about fitting through aisles'/
IWPD4 'Worry about finding chairs'/
IWPD5 'Experience discrimination'/
IWWRK1 'Trouble getting things accomplished'/
IWWRK2 'Less productive than I could be'/
IWWRK3 'Do not receive appropriate recognition'/
IWWRK4 'Afraid to go on job interviews'.
VAL LAB IWPF1 TO IWWRK4 5 'Always True' 4 'Usually True' 3 'Sometimes True' 2
'Rarely True' 1 'Never True'.
FORMAT IWPF1 TO IWWRK4 (F1.0).
MIS VAL IWPF1 TO IWWRK4 (9).
43
EXEC.
********************************************** NEW SCORING FOR BRIEF
IWQOL************************.
***** Compute PHYSICAL Score.
count missphys = IWPF1 TO IWPF11 (9,missing,sysmis).
do if (missphys lt 6).
compute IWPF = rnd((sum(IWPF1 TO IWPF11 )/(11-missphys))*11).
end if.
if (missphys ge 6) IWPF = 999.
var lab IWPF 'Physical Function Score (Brief)'.
mis val IWPF (999).
recode IWPF (sysmis=999).
freq missphys IWPF.
***** Compute SELF-ESTEEM Score.
count misssi = IWSE1 TO IWSE7 (9,missing,sysmis).
do if (misssi lt 4).
compute IWSE = rnd((sum(IWSE1 TO IWSE7 )/(7-misssi))*7).
end if.
if (misssi ge 4) IWSE = 999.
var lab IWSE 'Impact Self-Esteem (Brief)'.
mis val IWSE (999).
recode IWSE (sysmis=999).
freq misssi IWSE.
***** Compute SEXUAL LIFE Score.
count misssex = IWSEX1 TO IWSEX4 (9,missing,sysmis).
do if (misssex lt 3).
compute IWSEX = rnd((sum(IWSEX1 TO IWSEX4 )/(4-misssex))*4).
end if.
if (misssex ge 3) IWSEX = 999.
var lab IWSEX 'Impact Sexual Life Score (Brief)'.
mis val IWSEX (999).
recode IWSEX (sysmis=999).
freq misssex IWSEX.
***** Compute PUBLIC DISTRESS Score.
count misspub = IWPD1 TO IWPD5 (9,missing,sysmis).
do if (misspub lt 3).
compute IWPD = rnd((sum(IWPD1 TO IWPD5)/(5-misspub))*5).
end if.
if (misspub ge 3) IWPD = 999.
var lab IWPD 'Impact Public Distress Score (Brief)'.
mis val IWPD (999).
recode IWPD (sysmis=999).
freq misspub IWPD.
***** Compute WORK Score.
count misswrk = IWWRK1 TO IWWRK4 (9,missing,sysmis).
do if (misswrk lt 3).
compute IWWRK = rnd((sum(IWWRK1 TO IWWRK4 )/(4-misswrk))*4).
end if.
if (misswrk ge 3) IWWRK = 999.
var lab IWWRK 'Impact Work Score (Brief)'.
mis val IWWRK (999).
recode IWWRK (sysmis=999).
freq misswrk IWWRK.
***** Compute TOTAL Score.
count misstot = IWPF1 TO IWWRK4 (9,missing,sysmis).
do if (misstot lt 8).
compute IWTOT = rnd((sum(IWPF1 TO IWWRK4 )/(31-misstot))*31).
44
end if.
if (misstot ge 8) IWTOT = 999.
var lab IWTOT 'Impact Total Score (Brief)'.
mis val IWTOT (999).
recode IWTOT (sysmis=999).
freq misstot IWTOT.
FORMAT iwpf iwse iwsex iwpd iwwrk iwtot (F3.0).
**************** CONVERT SCORES TO T-SCORE FORMAT *******************.
compute iwpft = ((55-iwpf)/44)*100.
compute iwset = ((35-iwse)/28)*100.
compute iwsext = ((20-iwsex)/16)*100.
compute iwpdt = ((25-iwpd)/20)*100.
compute iwwrkt = ((20-iwwrk)/16)*100.
compute iwtott = ((155-iwtot)/124)*100.
exec.
var lab iwpft 'IWQOL Physical Function T-Score'/
iwset 'IWQOL Self-Esteem T-Score'/
iwsext 'IWQOL Sexual Life T-Score'/
iwpdt 'IWQOL Public Distress T-Score'/
iwwrkt 'IWQOL Work T-Score'/
iwtott 'IWQOL Total T-Score'.
format iwpft to iwtott (f5.1).
recode iwpft to iwtott (sysmis=999).
mis val iwpft to iwtott (999).
45
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47
Publications for IWQOL-Lite (and its predecessor IWQOL)
Kolotkin RL, Head S, Hamilton MA, Tse CTJ. Assessing impact of weight on quality of
life. Obesity Research. 1995;3:49-56.
Kolotkin RL, Crosby RD, Kosloski KD, Williams GR. Development of a brief measure
to assess quality of life in obesity. Obesity Research. 2001;9:102-111.
Kolotkin RL, Crosby RD. Psychometric evaluation of the Impact Of Weight On Quality
Of Life-Lite Questionnaire (IWQOL-Lite) in a community sample. Quality of Life
Research. 2002;11:157-171.
Rieger E, Wilfley DE, Stein RI, Marino V, Crow SJ. A comparison of quality of life in
obese individuals with and without binge eating disorder. International Journal of Eating
Disorders. 2005;37:234-240.
48
Engel, S.G., Kolotkin, R.L, Teixeira P,J., Sardinha L.B., Vieira P.N., Palmeira A.L.,
Crosby R.D. Psychometric and Cross-National Evaluation of a Portuguese Version of the
Impact of Weight on Quality of Life-Lite (IWQOL-Lite) Questionnaire. European Eating
Disorders Review. 2005;13:133-143.
Adami G.F., Ramberti G., Weiss A., Carlini F., Murelli F., Scopinaro N. Quality of life in
obese subjects following biliopancreatic diversion. Behavioral Medicine. 2005;31:53-60.
Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha
LB, Lohman TG: Pretreatment predictors of attrition and successful weight management
in women. International Journal of Obesity. 2004;28:1124-33.
Teixeira PJ, Palmeira AL, Branco TL, Martins SS, Minderico CS, Barata JT, Silva AM,
Sardinha LB: Who will lose weight? A reexamination of predictors of weight loss in
women. International Journal of Behavioral Nutrition and Physical Activity. 2004;1:12.
Kolotkin, R.L., Westman, E.C., stbye, T., Crosby, R.D., Binks, M., Eisenson, H.E.
Weight-related Quality of Life in Obese Persons With and Without Binge Eating
Disorder. Obesity Research. 2004;12:999-1005.
White, M.A., O'Neil, P. M, Kolotkin, R.L, Byrne, T.K. Gender, Race, and Obesity-
Related Quality of Life at Extreme Levels of Obesity. Obesity Research. 2004;12:949-
955.
Crosby RD, Kolotkin RL, Williams GR. An integrated method to determine meaningful
changes in health-related quality of life. Journal of Clinical Epidemiology. 2004;57:1153-
60.
Boan J, Kolotkin RL, Westman EC, McMahon RL, Grant JP. Binge Eating, Quality of
Life and Physical Activity Improve After Roux-en-Y Gastric Bypass (RYGB) for Morbid
Obesity. Obesity Surgery. 2004;14:341-348.
Brazier JE, Kolotkin RL, Crosby RD, Williams GR. Estimating a Preference-Based
Single Index for the Impact of Weight on Quality of Life-Lite Instrument (IWQOL-Lite)
from the SF-6D. Value in Health. 2004;7:490-498.
Korolija, D.; Sauerland, S.; Wood-Dauphinee, S.; Abbou, C. C.; Eypasch, E.; Caballero,
M. G.; Lumsden, M. A.; Millat, B.; Monson, J. R.; Nilsson, G.; Pointner, R.; Schwenk,
W.; Shamiyeh, A.; Szold, A.; Targarona, E.; Ure, B.; Neugebauer, E. Evaluation of
quality of life after laparoscopic surgery: evidence-based guidelines of the European
Association for Endoscopic Surgery. Surgical Endoscopy 2004; 18: 879-897.
Engel SG, Crosby RD, Kolotkin RL, Hartley GG, Williams GR, Wonderlich SA,
Mitchell JE. The Impact of Weight Loss and Regain on Obesity-Specific Quality of Life:
Mirror Image or Differential Effect. Obesity Research. 2003;11:1207-1213.
49
Gadde KM, Franciscy DM, Wagner HR, Krishnan RR. Zonisamide for weight loss in
obese adults. Journal of the American Medical Association. 2003;289:1820-1825.
Ballantyne GH. Measuring outcomes following bariatric surgery: weight loss parameters,
improvement in co-morbid conditions, change in quality of life and patient satisfaction.
Obesity Surgery. 2003;13:954-64.
de Zwaan M, Mitchell JE, Howell LM, Monson N, Swan-Kremeier L, Crosby RD, Seim
HC. Characteristics of morbidly obese patients before gastric bypass surgery.
Comprehensive Psychiatry. 2003;44:428-34.
Kolotkin RL, Crosby RD, Williams GR. Assessing weight-related quality of life in obese
persons with type 2 diabetes. Diabetes Research and Clinical Practice. 2003;61:125-32.
Kolotkin RL, Crosby RD, Pendleton R et al. Health-related quality of life in patients
seeking gastric bypass surgery vs. non-treatment-seeking controls. Obesity Surgery.
2003;13:371-7.
Heshka, S., Anderson, J. W., Atkinson, R. L., Greenway, F. L., Hill, J.O., Phinney, S.D.,
Kolotkin, R. L., Miller-Kovach, K., and Pi-Sunyer, F.X. Weight loss with self-help
compared with a structured commercial program. Journal of the American Medical
Association. 2003;289:1792-1798.
Dymek MP, Le Grange D, Neven K, Alverdy J. Quality of life after gastric bypass
surgery: a cross-sectional study. Obesity Research. 2002;10:1135-42.
Kolotkin RL, Crosby RD, Williams GR. Health-related quality of life varies among obese
subgroups. Obesity Research. 2002;10:748-756.
Fontaine KR. Health-related quality of life among obese subgroups: Editorial. Obesity
Research. 2002;10:854-855.
Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Martin CJ, Metcalfe LL, Finkenthal
NR, Blew RM, Sardinha LB, Lohman TG: Weight loss readiness in middle-aged women:
psychosocial predictors of success for behavioral weight reduction. Journal of Behavioral
Medicine. 2002;25: 499-523.
50
Wadden TA, Phelan S. Assessment of quality of life in obese individuals. Obesity
Research. 2002;10 Suppl 1:50S-7S.
Kolotkin RL, Crosby RD, Williams GR et al. The relationship between health-related
quality of life and weight loss. Obesity Research. 2001;9:564-571.
Kolotkin RL, Meter K, Williams GR. Quality of life and obesity. Obesity Reviews.
2001;2:219-229.
Samsa GP, Kolotkin RL, Williams GR et al. Effect of moderate weight loss on health-
related quality of life: an analysis of combined data from 4 randomized trials of
sibutramine vs. placebo. American Journal of Managed Care. 2001;7:875-883.
Fujioka K, Seaton TB, Rowe E, et.al. Weight loss with sibutramine improves glycemic
control and other metabolic parameters in obese patients with type 2 diabetes mellitus.
Diabetes Obesity and Metabolism. 2000;2:175-184.
51
Acknowlegements:
We acknowledge the generous sharing of data from the following organizations:
52