Twelve years’ experience with the Patient Generated Index (PGI) of quality of life: a graded structured review Faith Martin Æ Laura Camfield Æ Karen Rodham Æ Petra Kliempt Æ Danny Ruta Received: 14 March 2006 / Accepted: 2 December 2006 / Published online: 1 February 2007 Ó Springer Science+Business Media B.V. 2007 Abstract The Patient Generated Index (PGI) is an individualised quality of life (QoL) measure that has been in use since 1994. Various adaptations have been made to suit a variety of client groups. The PGI’s psychometric properties have been studied but their review is necessary to inform instrument choice. This article provides a structured review, using grading cri- teria adapted from those developed to aid outcome measure selection for use with older people. These criteria grade quality of evidence and strength of findings for psychometric validity, providing a useful model for future reviews. All published articles pro- viding data addressing validity, reliability and/or responsiveness were included in the review. Eighteen relevant articles were identified and analysed using the grading criteria. Variable results and quality of inves- tigation were seen. Generally the measure was found to be adequately reliable for group comparisons. The PGI appeared valid but evidence for responsiveness was unclear. Those versions of the measure using fewer points in their Likert scales may have higher reliability. Cognitions involved in QoL judgements remain little understood and investigations of psychometric prop- erties may be enhanced by examination of appraisal processes. Keywords Quality of life Á Outcome assessment Á Psychometrics Á Patient Generated Index Á Individualised QoL Introduction Individualised approaches to quality of life (QoL) assessment are predicated on the belief that only the individual living a life is fit to judge its quality [20]. These instruments allow individuals to select, rate and weight the relative importance of those aspects of their life they consider of greatest relevance to overall QoL. Unlike conventional patient-reported outcome mea- sures, with standardised questionnaire items and scor- ing of responses, individualised instruments purport to be able ‘to address the diversity of priorities and con- cerns of respondents and the varying weights and val- ues which they attach to their concerns’ [10]. It has been suggested that by excluding questionnaire items not directly of concern to the individual, these instru- ments are able to eliminate the ‘noise’ present in conventional standardised instruments, leading to im- proved responsiveness to change [45]. Two such instruments that have received attention in the health Electronic Supplementary Material The online version of this article (doi10.1007/s11136-006-9152-6) contains supplementary material, which is available to authorized users. F. Martin (&) Á L. Camfield WeD 3 East, University of Bath, Bath BA2 7AY, UK e-mail: psmfm@bath.ac.uk K. Rodham Department of Psychology, University of Bath, Bath BA2 7AY, UK P. Kliempt Wolfson Hyperbaric Medicine Unit, Ninewells Hospital, Level 7, University of Dundee, Dundee DD1 9SY, UK D. Ruta School of Population and Health Sciences, University of Newcastle, William Leech Building, The Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UK 123 Qual Life Res (2007) 16:705–715 DOI 10.1007/s11136-006-9152-6