Major Life Changing Decision Profile

The Major Life Changing Decision Profile (MLCDP) is designed to assist patients, clinicians and support services to better manage and minimise the impact of chronic disease by revealing information about affected goals and ambitions.

MLCDP data also provides structured insight into the life-long burden of chronic disease.

About the questionnaire

The MLCDP is a 32-question questionnaire. There are five domains (sections):

• education - three questions.
• job/career - nine questions.
• family/relationships - five questions.
• social - 10 questions.
• physical - five questions.

The questions were developed by interviewing patients with chronic (more than one year) conditions affecting the heart, lungs, joints, kidneys, skin and those who had diabetes. The MLCDP was validated in patients from the six specialties cardiology, nephrology, respiratory medicine, diabetes, rheumatology and dermatology.

The MLCDP is primarily designed for single use. This is because the time basis for the questions is the whole period during which the respondent has had the chronic health condition or disease.

The MLCDP is not designed to measure change following intervention. However, it could be used, for example once every five years, to determine whether any additional major life changing decisions have been affected.

Age range

The MLCDP is designed to be completed by any adult person with any chronic (more than one year) health condition or disease, aged 16 years or over.

Recall period

The MLCDP is designed to record any influences on, or changes to, major life changing decisions caused by having a chronic health condition or disease. When answering the questions, the person is asked to consider the period of their life since developing the condition.

Who can use it

Any adult who has suffered from, or is suffering from, any chronic health condition or disease can complete the questionnaire.

This questionnaire can be used in a range of settings by clinicians, pharmaceutical companies, with-profit organisations, students or researchers.

Depending on who you are and what you're using the questionnaire for, you may need to apply for licence and pay a fee.

Learn more about who can use this questionnaire and how to administer it.

Download the questionnaire

Different language versions

This zip file contains the questionnaires in Polish, along with the translation certificates. Find out more about our translation and linguistic validation process, and what to do if you'd like to create a new translation.

How to score it

The MLCDP can be interpreted in three different ways

Overall score: number of major life decisions affected by condition/disease

The MLCDP score is calculated by adding up the number of major life changing decisions that have been affected in any way, i.e. the number of questions to which the answer is anything other than 'No influence' or 'Not applicable'.

The minimum 'Simple' score is 0 = no major decisions affected.

The maximum 'Simple' score is 32 = 32 major decisions affected.

The total number of decisions affected is the most critical information in comparing the overall impact of having a disease on major life-changing decisions.

Graded response scoring system

This is an alternative method to score the MLCDP. Having graded score information may be of value to a clinician or other carer when counselling a patient.

The graded response scoring method uses the detailed information contained by answering each question using the grades:

As there are 32 questions, the total maximum score is 32x4 = 128

Domain (section) scores

Each of the five domains can be given a total score:

Copyright and registration

The MLCDP is protected under copyright, so you must not change the format, wording or design of the questionnaire.

This copyright statement must always be reproduced at the end of every copy of the MLCDP.

The MLCDP is copyright world-wide and can only be reprinted with permission (except for routine clinical purposes).  Every copy of the MLCDP, in whatever language, must reprint the copyright statement at the end of the MLCDP.

© Z U Bhatti, M S Salek, A Y Finlay, April 2011

Original publication

Bhatti ZU, Salek SS, Bolton CE, George L, Halcox JP, Jones SM, Ketchell IR, Moore RH, Sabit R, Piguet V, Finlay AY. The development and validation of the Major Life Changing Decision Profile (MLCDP).  Health and Quality of Life Outcomes 2013; May 8: 11 (1): 78 (epub).

Other key references

• Bhatti ZU, Salek MS, Finlay AY. Chronic diseases influence major life changing decisions: a new domain in quality of life research. Journal of the Royal Society of Medicine 2011; 104: 241-250.
• Bhatti ZU, Salek S, Finlay AY. Concept of Major Life Changing Decisions in life course research.  Chapter in: Cumulative Life Impairment by dermatological diseases. Editors: A Kimball, D Linder. Current Problems in Dermatology 2013; 44: 52-66.
• Bhatti ZU, Finlay AY, Bolton CE, George L, Halcox JP, Jones SM, Ketchell RI, Moore RH, Salek MS. Chronic disease influences over 40 major life changing decisions (MLCDs): a qualitative study in dermatology and general medicine. Journal of the European Academy of Dermatology and Venereology 2014; 28: 1344-1355.
• Wójcik E, Reszke R, Krajewski PK, Matusiak Ł, Madziarska K, Ali FM, Finlay AY, Szepietowski JC. Major life changing decision profile: Creation of the Polish language version.
  Dermatol Ther. 2021 Jan;34(1):e14568.

Contact us

If you have any questions, or if you have feedback on our web pages, please get in touch.

General queries

Licencing, financial and contractual enquiries

Authors of the MLCDP

• Professor Andrew Y Finlay
• Professor Sam Salek
• Dr Z U Bhatti