Skip to main content
Top
Published in: Osteoporosis International 4/2006

01-04-2006 | Original Article

Development of the Qualeffo–31, an osteoporosis-specific quality-of-life questionnaire

Authors: N. M. van Schoor, D. L. Knol, C. A. W. Glas, R. W. J. G. Ostelo, A. Leplège, C. Cooper, O. Johnell, P. Lips

Published in: Osteoporosis International | Issue 4/2006

Login to get access

Abstract

Introduction

Vertebral deformities are a common consequence of osteoporosis and are known to decrease quality of life. The Qualeffo–41 is a quality-of-life questionnaire especially developed for measuring quality of life in patients with vertebral deformities. It consists of 41 questions arranged in five domains: pain, physical function, social function, general health perception, and mental function. The objectives of this study were: (1) to develop a shorter version of the Qualeffo–41 by removing redundant questions; and (2) to investigate the scale characteristics, reliability, and validity of this shorter version.

Methods

The study was performed using data from the Qualeffo validation study and the Multiple Outcomes of Raloxifene Evaluation (MORE) study. The analyses were performed in patients with vertebral deformities (n=579). Factor analysis on polychoric correlations and an item response theory (IRT) model, i.e., the generalized partial credit model (GPCM), were used to create a shorter version of Qualeffo–41. Using GPCM, scoring weights were computed for all items.

Results

Three items were removed from the data set because of too many missing values. Factor analysis identified three instead of five domains: (1) pain, (2) physical function, and (3) mental function. Five items had factor loadings <0.4 and were not included in the GPCM. After excluding several items, the domains pain (four items), physical function (18 items), and mental function (nine items) showed a good, reasonable, and excellent fit, respectively. This indicates that the mental function domain and the pain domain are more unidimensional than the physical function domain. All three domains showed a very high correlation (r ≥0.95) with the corresponding domains of the Qualeffo–41.

Conclusions

Qualeffo–31 was developed, consisting of three domains with a reasonable to excellent fit to the GPCM. Although the fit to the GPCM supports the construct validity of the Qualeffo–31, validation in a new study should be performed before using it in practice.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hasserius R, Redlund–Johnell I, Mellstrom D, Johansson C, Nilsson BE, Johnell O (2001) Vertebral deformation in urban Swedish men and women – Prevalence based on 797 subjects. Acta Orthop Scand 72:273–278CrossRefPubMed Hasserius R, Redlund–Johnell I, Mellstrom D, Johansson C, Nilsson BE, Johnell O (2001) Vertebral deformation in urban Swedish men and women – Prevalence based on 797 subjects. Acta Orthop Scand 72:273–278CrossRefPubMed
2.
go back to reference Jones G, White C, Nguyen T, Sambrook PN, Kelly PJ, Eisman JA (1996) Prevalent vertebral deformities: Relationship to bone mineral density and spinal osteophytosis in elderly men and women. Osteoporos Int 6:233–239CrossRefPubMed Jones G, White C, Nguyen T, Sambrook PN, Kelly PJ, Eisman JA (1996) Prevalent vertebral deformities: Relationship to bone mineral density and spinal osteophytosis in elderly men and women. Osteoporos Int 6:233–239CrossRefPubMed
3.
go back to reference Lau EMC, Woo J, Chan H, Chan MKF, Griffith J, Chan YH et al (1998) The health consequences of vertebral deformity in elderly Chinese men and women. Calcif Tissue Int 63:1–4CrossRefPubMed Lau EMC, Woo J, Chan H, Chan MKF, Griffith J, Chan YH et al (1998) The health consequences of vertebral deformity in elderly Chinese men and women. Calcif Tissue Int 63:1–4CrossRefPubMed
4.
go back to reference Melton LJ III, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3:113–119CrossRefPubMed Melton LJ III, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3:113–119CrossRefPubMed
5.
go back to reference Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P (2000) Consequences of vertebral deformities in older men and women. J Bone Miner Res 15:1564–1572PubMedCrossRef Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P (2000) Consequences of vertebral deformities in older men and women. J Bone Miner Res 15:1564–1572PubMedCrossRef
6.
go back to reference Silverman SL (1992). The clinical consequences of vertebral compression fracture. Bone 13 (Suppl 2):S27–31 Silverman SL (1992). The clinical consequences of vertebral compression fracture. Bone 13 (Suppl 2):S27–31
7.
go back to reference Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al (1999) Quality of life in patients with vertebral fractures. Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporos Int 10:150–160CrossRefPubMed Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al (1999) Quality of life in patients with vertebral fractures. Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporos Int 10:150–160CrossRefPubMed
9.
go back to reference Lips P, Agnusdei D, Caulin F, Cooper C, Johnell O, Kanis J et al (1996) The development of a European questionnaire for quality of life in patients with vertebral osteoporosis. Scand J Rheumatol (Suppl) 103:84–85PubMedCrossRef Lips P, Agnusdei D, Caulin F, Cooper C, Johnell O, Kanis J et al (1996) The development of a European questionnaire for quality of life in patients with vertebral osteoporosis. Scand J Rheumatol (Suppl) 103:84–85PubMedCrossRef
10.
go back to reference Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al (1997) Quality of life as outcome in the treatment of osteoporosis: the development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporos Int 7:36–38CrossRefPubMed Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al (1997) Quality of life as outcome in the treatment of osteoporosis: the development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporos Int 7:36–38CrossRefPubMed
11.
go back to reference Hays RD, Morales LS, Reise SP (2000) Item response theory and health outcomes measurement in the 21st century. Med Care 38:28–42CrossRef Hays RD, Morales LS, Reise SP (2000) Item response theory and health outcomes measurement in the 21st century. Med Care 38:28–42CrossRef
12.
go back to reference Cella D, Chang CH (2000) A discussion of item response theory and its applications in health status assessment. Med Care 38:66–72CrossRef Cella D, Chang CH (2000) A discussion of item response theory and its applications in health status assessment. Med Care 38:66–72CrossRef
13.
go back to reference Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C et al (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedCrossRef Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C et al (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedCrossRef
14.
go back to reference Jöreskog KG, Sörbom D (1996) Prelis 2 User’s Reference Guide. Mooresville: SSI Scientific Software Jöreskog KG, Sörbom D (1996) Prelis 2 User’s Reference Guide. Mooresville: SSI Scientific Software
15.
go back to reference Flora DB, Finkel EJ, Foshee VA (2003) Higher order factor structure of a self-control test: Evidence from confirmatory factor analysis with polychoric correlations. Educ Psychol Meas 63:112–127CrossRefMathSciNet Flora DB, Finkel EJ, Foshee VA (2003) Higher order factor structure of a self-control test: Evidence from confirmatory factor analysis with polychoric correlations. Educ Psychol Meas 63:112–127CrossRefMathSciNet
16.
go back to reference Streiner DL (1994) Figuring out factors - the use and misuse of factor-analysis. Can J Psychiatry 39:135–140PubMed Streiner DL (1994) Figuring out factors - the use and misuse of factor-analysis. Can J Psychiatry 39:135–140PubMed
17.
go back to reference Muraki E (1992) A generalized partial credit model-application of an EM algorithm. Applied Psychological Measurement 16:159–176CrossRef Muraki E (1992) A generalized partial credit model-application of an EM algorithm. Applied Psychological Measurement 16:159–176CrossRef
18.
go back to reference Glas CAW (1999) Modification indices for the 2–PL and the nominal response model. Psychometrika 64:273–294CrossRef Glas CAW (1999) Modification indices for the 2–PL and the nominal response model. Psychometrika 64:273–294CrossRef
19.
go back to reference Glas CAW, Falcon JCS (2003) A comparison of item-fit statistics for the three–parameter logistic model. Applied Psychological Measurement 27:87–106CrossRefMathSciNet Glas CAW, Falcon JCS (2003) A comparison of item-fit statistics for the three–parameter logistic model. Applied Psychological Measurement 27:87–106CrossRefMathSciNet
20.
go back to reference van Buuren S, Hopman-Rock M (2001) Revision of the ICIDH Severity of Disabilities Scale by data linking and item response theory. Stat Med 20:1061–1076CrossRefPubMed van Buuren S, Hopman-Rock M (2001) Revision of the ICIDH Severity of Disabilities Scale by data linking and item response theory. Stat Med 20:1061–1076CrossRefPubMed
21.
go back to reference Rasch G (1960) Probabilistic models for some intelligence and attainment tests. Copenhagen: Danish Institute for Educational Research Rasch G (1960) Probabilistic models for some intelligence and attainment tests. Copenhagen: Danish Institute for Educational Research
22.
go back to reference Verhelst ND, Glas CAW, Verstralen HHFM (1995) One-Parameter Logistic Model OPLM. Arnhem: CITO Verhelst ND, Glas CAW, Verstralen HHFM (1995) One-Parameter Logistic Model OPLM. Arnhem: CITO
23.
go back to reference Ware JE, Bjorner JB, Kosinski M (2000) Practical implications of item response theory and computerized adaptive testing–A brief summary of ongoing studies of widely used headache impact scales. Med Care 38:73–82CrossRef Ware JE, Bjorner JB, Kosinski M (2000) Practical implications of item response theory and computerized adaptive testing–A brief summary of ongoing studies of widely used headache impact scales. Med Care 38:73–82CrossRef
Metadata
Title
Development of the Qualeffo–31, an osteoporosis-specific quality-of-life questionnaire
Authors
N. M. van Schoor
D. L. Knol
C. A. W. Glas
R. W. J. G. Ostelo
A. Leplège
C. Cooper
O. Johnell
P. Lips
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 4/2006
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-005-0024-7

Other articles of this Issue 4/2006

Osteoporosis International 4/2006 Go to the issue