To develop reference ranges for the Questions on Life Satisfaction Hypopituitarism Module (QLS-H), a new quality of life questionnaire for patients with hypopituitarism, data from 8177 adults were collected in France, Germany, Italy, The Netherlands, Spain, the United Kingdom, and the United States QLS-H scores declined with age, were lower in females than males, and differed significantly among countries. From these reference ranges we derived equations for z-scores, which adjust for age, gender, and country. QLS-H results from 957 adults with GH deficiency (GHD) participating in clinical trials were analyzed. At baseline, QLS-H scores were lower in females and differed significantly among countries. QLS-H scores significantly increased after GH treatment (6-8 months), but differences by country persisted. Calculating z-scores for patients eliminated all gender and most country differences. Pooled z-scores (mean ± SD) from all patients increased from -0.99 ± 1.39 at baseline to -0.14 ± 1.30 after GH treatment. Quality of life assessment in adults with GHD requires the use of z-scores to correct for age, gender, and country differences. This approach allows pooling of data from different cohorts and comparison with general populations. QLS-H scores in adults with GHD were significantly decreased at baseline and were almost normalized after 6-8 months of GH therapy.

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Journal Journal of Clinical Endocrinology and Metabolism
Blum, W.F, Strasburger, C.J, Henrich, T.J, Herschbach, P, Shavrikova, E.P, Edwards, D.J, … Attanasio, A.F. (2003). Decreased quality of life in adult patients with growth hormone deficiency compared with general populations using the new, validated, self-weighted questionnaire, Questions on Life Satisfaction Hypopituitarism Module. Journal of Clinical Endocrinology and Metabolism, 88(9), 4158–4167. doi:10.1210/jc.2002-021792