OBJECTIVES: Response sift (RS) and recall bias (RB) cause problems in patient-reported outcomes (PRO). RS refers to the change of meaning in health-related quality of life (HRQoL) in pretest-posttest design. RB is the result of variation in the recall of earlier HRQoL states, satisfaction and symptoms. To present a new composite HRQoL tool for integrating contemporaneous items with recall/response items. The innovative aim of the generic 15Ds tool is the adjustment of RB/RS. METHODS: The widely utilized 15D tool yields both 15-dimensional health profiles and an overall HRQoL index. The 15D was promoted by the WHO health definition and the additive valuation of multiattribute utility theory (MAU) to produce quality-adjusted life years (QALY). The 15Ds was innovated by the literature and pragmatic experience with the 15D. RESULTS: The 15Ds contains 15 contemporary dimensions with five states (i.e. the conventional 15D), 15 recall/response dimensions with six states for transitions, and three validation dimensions. The recall/response dimensions adjust subjects' contemporary states for RB/RS. The validation dimensions contain a comparison of the subject's general health state to the health of a same-age population (5 states), RB/RS comparison for health transitions (6 states), and comparison for the level of healing (illness conceptualization, 5 states). A preliminary analysis revealed that patients have more sensitivity for changes measured as the recall/response items than for changes in the contemporary items over time. The 15Ds gives slightly better outcomes in the index changes and offers higher discrimination for the changes of HRQoL when compared with the conventional 15D. CONCLUSIONS: The 15Ds can produce 15-dimensional contemporary health profiles, 15-dimensional recall/response health profiles, overall HRQoL index for both 15Ds and 15D, and approximations for the validation of transitions, health and illness. The 15Ds is recommended for recall (e.g. acute conditions when no baseline HRQoL is obtainable) and RB/RS adjustment.