Use of the 15D

Ways of using the 15D

The instrument can be used for

  • assessing effectiveness and efficiency (cost-effectiveness/utility) of health care programmes and technologies

  • measuring and monitoring health status and HRQoL of patients and population groups, and whole populations

  • improving medical decision making by

    • identifying health problems of individual patients (use as a diagnostic tool) and

    • following-up their health status and HRQoL in a standard way as a part of medical records

  • setting output objectives for hospitals/clinics/wards and measuring their output

  • standardising patient-mix when comparing and analysing the productivity of hospitals/clinics/wards

The 15D instrument is recommended by the Washington Panel (Gold M et al. (eds.) Cost-effectiveness in health and medicine. Oxford University Press, New York and Oxford 1996).

Use as a profile instrument

When a person fills in the 15D questionnaire, the result is a 15-dimensional description of her/his health status. It shows the position of the person on the levels of each of the 15 dimensions of health. This is referred to as the 15D profile.

Similarly, a 15D profile for a group of persons (patients, population) can be constructed from the average position of the group on the levels of each of the 15 dimensions. It is recommended that the profiles are constructed on a 0-1 scale by using the variables, where the original ordinal numbers of the levels (1-5) have been replaced by level values produced by the valuation system.

Diseases/conditions/health problems studied

Drug evaluations:

  1. Breast cancer (tamoxifen vs. toremifen)
  2. Depression (fluoxetine vs. moclobemide, fluoxetine vs. dothiepine)
  3. Seasonal affective disorder (fluoxetine vs. moclobemide)
  4. Restenosis prevention after PTCA
  5. Osteoporosis (alendronate)
  6. A gastro-intestinal disorder (three drugs)
  7. Parkinson’s disease
  8. Chronic obstructive lung disease (COPD)
  9. Early rheumatoid arthritis (single drug treatment vs. 4-drug combination)
  10. Healthy postmenopausal women (hormone replacement therapy)
  11. Schizophrenia
  12. Psoriasis
  13. MS disease (interferon vs. not)


  1. Coronary artery disease (CABG, re-CABG, PTCA, conservative treatment).
  2. Knee and hip replacements
  3. Hip fracture
  4. Epilepsy (surgery vs. no surgery).
  5. Lumbar spinal stenosis (surgery vs. conservative treatment)
  6. Hallux valgus (surgery vs. conservative treatment)
  7. Herniated lumbar disc (surgery vs. conservative treatment)
  8. Adolescent idiopathic scoliosis (Harrington instrumentation)
  9. Varicose veins
  10. Gastrointestinal surgery
  11. Hernia
  12. Neurosurgery (several diagnoses)
  13. Esophageal cancer (surgery vs. palliative)
  14. Brain tumor
  15. Blood vessel surgery
  16. Breast cancer and reconstruction
  17. Breast reduction
  18. Lung cancer
  19. Severe obesity
  20. Hysterectomy
  21. Prostata hyperplasia
  22. Prostate cancer
  23. Bladder cancer
  24. Renal cancer
  25. Venuous leg ulcers (surgery vs. compression)
  26. Silicon implants
  27. Cataract
  28. Cochlear implant
  29. Incontinence (surgery vs. physiotherapy)
  30. Pneumonectomy


  1. Coronary artery disease (CAD) patients (rehabilitation)
  2. Employed people with reduced ability to work (vocationally oriented medical rehabilitation)
  3. Geriatric rehabilitation (n=741, aged 65+)
  4. Hip fracture (three approaches to rehabilitation)
  5. Holistic geriatric assessment, treatment and rehabilitation (n=1500, aged 75+)
  6. Inspiration activity of the elderly
  7. Lumbar disc herniation (muscle exercise program after surgery)
  8. MS patients (inpatient rehabilitation)
  9. Muscular strength training of the elderly
  10. Orthopaedic patients (rehabilitation)
  11. Physiotherapy
  12. Rehabilitation councelling of the elderly
  13. Speech rehabilitation
  14. Stroke (treatment, intensive vs. conventional rehabilitation)
  15. Sub-acute low back pain (early activation and rehabilitation)
  16. Visual impairment (rehabilitation)

Other conditions/treatments:

  1. Acoustic neurinoma
  2. Acromegaly
  3. Acute low back pain
  4. Aneurysma (celebral haemorrhage)
  5. Aphasia
  6. Arteriosclerotic disease (a multi-component intervention to prevent complications)
  7. Asthma (intensive vs. conventional patient education and supervision for self-management)
  8. Atopic eczema
  9. Atrial fibrillation
  10. Back pain in pregnant women (back supporting vest vs. conventional approach to treating back pain)
  11. Basedow’s disease
  12. Bipolar affective disorder
  13. Cancer of thyroid gland
  14. Chronic non-malignant pain (medical management)
  15. Diastrophic dysplasia
  16. Duchenne-Erb paresis
  17. Diabetes (prevention of type 2 in Finland; type 1 and 2 patients with different complications)
  18. Dizziness with migraine as an etiological factor
  19. Eating disorders
  20. Esophagus atresia
  21. ESRD
  22. Fabry’s disease
  23. FH
  24. Fibromyalgia
  25. Forearm fracture
  26. Glaucoma
  27. Gonarthritis
  28. Hearing problems
  29. HIV/AIDS
  30. Human papilloma virus (HPV)
  31. “Intelligent bracelet” for dementing elderly
  32. Irritable bowel syndrome
  33. Multiple myeloma
  34. Myocardial infarction
  35. Nephrolith
  36. Non-specific back pain
  37. Oral health
  38. Osteoarthritis
  39. Pancreatic exocrine insufficiency
  40. Patients coming to angiography
  41. Prostate cancer (screening and treatment)
  42. Sciatica
  43. Severe chronic pain (spinal cord stimulator)
  44. Severe obesity (combined VLCD and behaviour modification)
  45. Sleep apnea
  46. Sparm of celebral arteries
  47. Spinal cord injury
  48. Teleultrasound examination
  49. Treatment of psychosis
  50. Trigeminus neuralgia
  51. Weaning from smoking

Other projects:

  1. The Finnish National Health Survey 1995/96
  2. Health2000 survey in Finland (a random sample of 6329 of adult population aged 30+)
  3. Health2011 survey in Finland (a random sample of 5011 of adult population aged 18+)
  4. The Danish National Health Survey 2000.
  5. Experiment on feasibility and usefulness of measuring HRQoL of patients before and after treatment routinely in the hospitals of Helsinki and Uusimaa Hospital District
  6. Experiment on including the 15D as a standard part of anamnesis in electronic medical records (Turku University Hospital)
  7. DEBATE-study (Drugs and Evidence-Based Medicine in the Elderly) (n=400, aged 75+ with cardiovascular diseases)
  8. Elderly in Helsinki, Finland vs. in Tallinn, Estonia
  9. The process of frailty and disability in older women (The Finnish Twin Study on Ageing, FITSA).
  10. The HRQoL of young military conscripts (15D vs. Rand-36)