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. 2025 Mar;39(3):631-679.
doi: 10.1111/jdv.20321. Epub 2024 Sep 13.

The Dermatology Life Quality Index (DLQI) used as the benchmark in validation of 101 quality-of-life instruments: A systematic review

J Vyas  1 , J R Johns  2 , Y Abdelrazik  3 , F M Ali  2 , J R Ingram  2 , S Salek  4 , A Y Finlay  2
Affiliations

The Dermatology Life Quality Index (DLQI) used as the benchmark in validation of 101 quality-of-life instruments: A systematic review

J Vyas et al. J Eur Acad Dermatol Venereol. 2025 Mar.

Abstract

Background: The validation of psychometric measures requires use of other established and standardized validated measures. The Dermatology Life Quality Index (DLQI) is the most widely used tool to measure the burden of skin diseases and assess effectiveness of interventions based on patients' perspective.

Objectives: The objective of this study was to systematically analyse peer-reviewed publications describing use of the DLQI in validation of other patient-reported outcome (PRO) and quality-of-life (QoL) measures.

Methods: Seven databases were searched for papers published between January 1994 and December 2022 for articles containing data using DLQI in the validation of other PRO/QoL measures. The methodology followed PRISMA guidelines. The protocol was prospectively registered on PROSPERO.

Results: Of 1717 screened publications, 122 articles including 30,727 patients from 34 different countries with 41 diseases met the inclusion criteria. The DLQI was used in validation of 101 measures: 80 dermatology-specific QoL measures, mostly disease-specific, and 21 generic measures. Of these studies, 47 were cross-cultural adaptations, 116 single arm, 100 were cross-sectional, 18 longitudinal and six randomized placebo controlled. DLQI was used for 14 known group, and correlation for 10 construct, 101 convergent, 10 concurrent, 10 divergent/discriminant and three criterion validity tests using Mann-Whitney (2), Spearman's (80), Pearson's correlation (26) and Student's t-test (1). The DLQI was used in responsiveness analysis in 13 studies.

Conclusions: This review identified widespread use of the DLQI in validation of other dermatology PRO/QoL measures and confirmed the central role that the DLQI plays as a benchmark in instrument development and validation across dermatology and beyond. The use of the DLQI by so many developers of other instruments has provided a common standard for comparability.

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Conflict of interest statement

Andrew Y Finlay is joint copyright owner of the Dermatology Life Quality Index (DLQI). Cardiff University receives royalties from some use of the DLQI: AYF receives a proportion of these under standard university policy. John Ingram receives a stipend as Editor‐in‐Chief of the British Journal of Dermatology and an authorship honorarium from UpToDate. He is a consultant for Abbvie, Boehringer Ingelheim, ChemoCentryx, MoonLake, Novartis, UCB Pharma and Union Therapeutics, and has served on advisory boards for Insmed, Kymera Therapeutics and Viela Bio. He is co‐copyright holder of HiSQOL, Investigator Global Assessment and Patient Global Assessment instruments for HS. His department receives income from royalties from the DLQI and related instruments. Sam Salek has received an unrestricted educational grant from GSK, is a consultant for Novo Nordisk and produces educational materials for Abbvie. Jui Vyas participated in an Advisory Board for Amgen, has received payment or honoraria from L'Oreal and support from UCB pharma for attending meetings. Faraz Ali has received honorariums from Abbvie, Janssen, LEO pharmaceuticals, Lilly pharmaceuticals, L'Oreal, Novartis and UCB. His department receives income from royalties from the DLQI and related instruments. Jeffrey Johns has no conflicts of interest to report. His department receives income from royalties from the DLQI and related instruments. Yasmina Abdelrazik has no conflicts of interest to report.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram reporting the number of records identified from each database or searched and the number of articles matching the criteria that were included in the study.
FIGURE 2
FIGURE 2
Number of Dermatology Life Quality Index (DLQI) studies published in peer‐reviewed journals view by year.
See this image and copyright information in PMC

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