HRQOL questionnaire

All subjects were asked to complete a validated generic QOL questionnaire (WHOQOL-BREF, Taiwan version) in the outpatient clinic prior to medical treatment. The Taiwan version of the WHOQOL-BREF contains four domains (physical, psychological, social and environment), including the 26 original items of the WHOQOL-BREF, plus two culture-specific questions. One item addressing “respect from others” was categorized into the social domain, and another corresponded to “eating what one likes to eat” and was categorized to the environment domain. The method of application, the scoring procedures and reference time point (during the last 2 weeks) were the same as the original WHOQOL-BREF [28]. In brief, each item was scored from 1 to 5 points, and a higher score was considered a better QOL. Because the numbers of items are different for each domain, the domain scores were calculated by multiplying the average scores of all items in the domain by a factor of 4. Therefore, each domain score would have the same range, from 4 to 20.