Few health measurement instruments remain relevant for decades. Fewer still continue to be used, adapted, and trusted across disciplines, geographies, and use cases. Since its initial publication in 2001, the Work Limitations Questionnaire (WLQ) has demonstrated notable endurance, evolving into a family of rigorously validated instruments designed to assess the impact of health on work functioning and productivity. These include the WLQ, WLQ - Short Form (WLQ-SF), and Caregiver WLQ, each accompanied by a Time Loss Module for measuring work absence.
To mark the WLQ’s 25th anniversary, Mapi Research Trust spoke with its author, Dr. Debra Lerner, about the origins of the instrument and its continued relevance across diverse populations, industries and settings.
1. What insight or moment first convinced you that this concept needed to be measured?
I am a social scientist and have long been interested in how work and the workplace play a key role in determining the quality of our lives. I was also very interested in health and health care, and in how societies were coping with the rise of chronic illness and disability. I was fortunate to have wonderful mentors who encouraged me to explore work as a critical domain of health-related quality of life and the broader concept of quality of life. I quickly realized there were few tools available to research this topic and, ultimately, to contribute to improving the functioning and well-being of individuals who need and/or want to work.
2. Over the years, what has surprised you most about how researchers or clinicians use the WLQ today?
In the early years of the WLQ, I was surprised by the extent of adoption by employers, their insurers, and the health and wellness industry. While there were excellent generic and disease-specific questionnaires available, the WLQ was the first validated, practical tool for collecting and analyzing population-based data on the functional performance and productivity of employees in the work domain. Eventually, the term “presenteeism” began to circulate and today continues to be a key metric for evaluating the impact of health care, as well as pharmaceutical and organizational interventions.
3. What guidance would you offer to organizations, including insurers, providers of employer wellness programs, digital health providers, and researchers, who rely on the WLQ in practice?
Do your research and choose wisely. The importance of a survey instrument’s scientific quality (e.g., reliability and validity) across languages and formats, its practicality of use, and its acceptance by respondents cannot be overstated. Also important is the availability of norms, benchmarks, and comparative data. Survey instruments, even some that are quite popular, do not meet quality standards. Inaccurate assessments are costly, both economically and in terms of human health.
4. From your perspective, what value does partnering with Mapi Research Trust bring to the consistency, scientific integrity, and global use of the WLQ?
Mapi Research Trust has been a leader in establishing and maintaining quality standards and customer service. They have been at the forefront of partnering with organizations to expand the WLQ into numerous linguistic and cultural versions and to disseminate these globally. As a developer, this support has been essential.
Thank you to Dr. Lerner for taking the time to join us in reflecting on the remarkable journey of the WLQ. To access the WLQ, WLQ-SF, and Caregiver WLQ for use in your research, please visit ePROVIDE. An eBooklet with detailed instructions on digitizing the WLQ is also available.
Additional reading: Why developer guidelines are critical for COA digital migration | Mapi Research Trust