Based on the 15D, a version has been developed for adolescents aged 12-15 years (16D©/Marjo Apajasalo and Harri Sintonen). The instrument can also be used up to the age of 18. The health state descriptive system (questionnaire) includes 16 dimensions (ABBREVIATIONS in parentheses are variable names in the valuation algorithm, followed by the number of the dimension on the 16D questionnaire):

  • Mobility (MOVE, Q12)

  • Vision (SEE, Q2)

  • Hearing (HEAR, Q5)

  • Breathing (BREATH, Q3)

  • Sleeping (SLEEP, Q6)

  • Eating (EAT, Q7)

  • Speech (SPEECH, Q9)

  • Excretion (EXCRET, Q15)

  • School and hobbies (SCHOOL, Q11)

  • Mental function (MENTAL, Q14)

  • Discomfort and symptoms (DISCO, Q8)

  • Depression (DEPR, Q16)

  • Distress (DISTR, Q4)

  • Vitality (VITAL, Q1)

  • Appearance (APPEAR, Q10)

  • Friends (FRIEND, Q13)

Levels: 5 ordinal levels on each dimension, by which more or less of the attribute is distinguished. The respondent chooses from each dimension the level, which best describes her/his present health status.

Completion time: It takes 5-10 minutes to complete the questionnaire. Full instructions for completion are on the questionnaire.

Mode of administration: Primarily self-administration, but also interview- and proxy administration possible.

Languages: The 16D questionnaire is available so far in English, Finnish, French, Norwegian and Swedish.

Note: The dimension earlier called "elimination" has been changed to "excretion" to better reflect the content of that dimension.

Load the questionnaire.

The valuation system

The valuation system of the 16D is based on an application of the multi-attribute utility theory. The single index (16D score) on a 0‑1 scale, representing the overall HRQoL (0 = being dead, 1 = no problems on any dimension = ‘full’ HRQOL) is calculated from the health state descriptive system by using a set of population‑based preference or utility weights, which have been elicited from a sample of 12-15 years old school children with a similar methodology as applied with the 15D.

Most of what is said on this website on the 15D applies also to the 16D. For more information on the development and properties of the 16D, see Apajasalo M, Sintonen H, Holmberg C, Sinkkonen J, Aalberg V, Pihko H, Siimes MA, Kaitila I, Mäkelä A, Rantakari K, Anttila R, Rautonen J. Quality of life in early adolescence: A sixteen-dimensional health-related measure (16D). Quality of Life Research 5:1996; 205-211. The list of publications on this website includes also applications of this instrument. For more information and permission of use, please contact either one of the copyright holders (marjoapajasalo@yahoo.com or harri.sintonen@helsinki.fi).