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Health Related Quality of Life-14 (HRQOL-14)
The instrument is freely available here: Health Related Quality of Life- 14
Exploratory: Cerebral Palsy (CP), Headache, and Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Short Description of Instrument
The Centers for Disease Control and Prevention's (CDC) 14-item HRQOL "Healthy Days Measure" survey allows subjects to rate their overall health status and the influence of various symptoms on their daily activities. This is a publicly available, standardized instrument that allows comparisons of a subject's self-reported quality of life among various populations. The CDC HRQOL-14 is comprised of three different modules including the 4 question Healthy Days Core Module-4 (CDC-HRQOL-4), which allows individuals to rate their own physical and mental health status; the 5 question Activity Limitations module , which allows subjects to describe how their daily functionality may be limited by their physical, mental, or emotional problems; and the 5 question Healthy Days Symptoms module, which allows individuals to rate how pain, mood, anxiety, sleep and energy levels affect their daily life. Unhealthy days are an estimate of the overall number of days during the previous 30 days when the respondent felt that either his or her physical or mental health was not good.
Several organizations have found these Healthy Days measures useful at the national level for identifying health disparities, tracking population trends, and building broad coalitions around a measure of population health compatible with the World Health Organization's definition of health. The HRQOL measures and data have also been used for research or program planning by CDC's Cardiovascular Health and HIV/AIDS Programs as well as by the Public Health Foundation, the Foundation for Accountability, and several other government and academic programs.
Healthy Days Core Module – 4 (CDC-HRQOL-4):
"The standard 4-item set of core CDC HRQOL-4 questions has been in the State- based Behavioral Risk Factor Surveillance System (BRFSS) since 1993 (see BRFSS website ( From 2000 to 2012, the CDC HRQOL-4 has been in the National Health and Nutrition Examination Survey (NHANES) for persons aged 12 and older. Since 2003, the CDC HRQOL– 4 has been in the Medicare Health Outcome Survey (HOS)—a measure in the National Commission for Quality Assurance's (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS). Standard Activity Limitation (5 questions) and Healthy Days Symptoms (5 questions) modules have also been available since January 1995. When used together, these measures comprise the full CDC HRQOL-14 Measure." (see:
Unlike other health profiles, the CDC HRQOL-14 does not use a summary score and is not based on psychometrically derived or preference-based weights.
Unhealthy days are an estimate of the overall number of days during the previous 30 days when the respondent felt that either his or her physical or mental health was not good. To obtain this estimate, responses to questions 2 and 3 from the CDC HRQOL-4 are combined to calculate a summary index of overall unhealthy days, with a logical maximum of 30 unhealthy days. Healthy days are the positive complementary form of unhealthy days. Healthy days estimate the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days. Statistical computer software packages that analyze data are available.
The CDC HRQOL-14 is one of many questionnaires that provide a summary score of an individual's overall perceived health status and health-related functional disability. Many headache disorders influence an individual's overall health and functional abilities. Therefore, it may be useful in some acute headache clinical trials to measure global health status. The CDC HRQOL-14 is a commonly used instrument with defined test characteristics. It is easy to administer and publicly available. Because it is not specific to headache, the CDC HRQOL-14 can allow comparison with other symptoms and diseases. This instrument will be useful in acute headache therapeutic trials that seek to determine the influence of a therapy on longer-term outcomes. Investigators searching for a measure of global health status can choose between this instrument and other similar instruments such as the SF-12 and the SF-36.
CDC HRQOL-14 Measure Web site: CDC HRQOL-14 Measure
Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention's Healthy Days Measures - population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37.


Document last updated July 2019
Recommended Instrument for
CP, Headache, ME/CFS