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PharmacoEconomics
Published in: PharmacoEconomics 5/2002

01-04-2002 | Review Article

Quality-of-Life Assessment in Osteoporosis

Health-Status and Preference-Based Measures

Authors: Dr Anna N. A. Tosteson, Cristina S. Hammond

Published in: PharmacoEconomics | Issue 5/2002

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Abstract

Health-status and preference-based approaches to assessing health-related quality of life (HR-QOL) in osteoporosis are reviewed. Osteoporosis-targeted health-status instruments [i.e. Osteoporosis Quality-of-Life Questionnaire (OQLQ), Osteoporosis Assessment Questionnaire (OPAQ), Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO), Osteoporosis-Targeted Quality-of-Life Questionnaire (OPTQoL), Osteoporosis Functional Disability Questionnaire (OFDQ), Quality-of-Life Questionnaire in Osteoporosis (QUALIOST)], which have been utilised to document the adverse impact of osteoporosis on HR-QOL in diverse clinical and epidemiological studies, are described first. Preference-based approaches to osteoporosis health-outcome measurement are then considered in both clinical and health policy settings. In the clinical setting, direct preference assessments [i.e. visual analogue scale (VAS), time tradeoff (TTO), standard gamble (SG)] using either experienced or described health outcomes have consistently shown significantly lower values for osteoporosis-related health states relative to usual or ideal health. In the health-policy context, preference-classification systems [i.e. EuroQoL (EQ-5D), Health Utilities Index (HUI)] for valuing health in economic studies are reviewed. At present, there is little evidence to guide the choice of one system over another for assessing the cost effectiveness of osteoporosis interventions; however, use of a consistent set of health-state values is essential. Further research is needed to characterise associations between osteoporosis-targeted health-status instruments and preference-based health-outcome measures. In addition, the longitudinal impact of osteoporosis and related fractures on HR-QOL must be documented.
Literature
1.
Ray WA, Griffin MR, Baugh DK. Mortality following hip fracture before and after implementation of the prospective payment system. Arch Intern Med 1990; 150 (10): 2109–14PubMedCrossRef
2.
Avioli LV. Socio-economic costs of osteoporosis and changing patterns. Ann Chir Gynaecol 1988; 77: 168–72PubMed
3.
Avioli LV. Significance of osteoporosis: a growing international health care problem. Calcif Tissue Int 1991; 49 (Suppl.): S5–7PubMedCrossRef
4.
5.
Randell AG, Sambrook PN, Nguyen TV, et al. Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 1995; 5: 427–32PubMedCrossRef
6.
US Bureau of the Census. Population projections of the United States by age, sex, race and Hispanic origin: 1995 to 2050. Washington, DC: U.S. Government Printing Office, 1996. Currrent Population Report No.: P25-1130
7.
Hollingworth W, Todd CJ, Parker MJ. The cost of treating hip fractures in the twenty-first century: short report. Osteoporos Int 1996; 6 Suppl. 2: 13–5PubMedCrossRef
8.
Cauley JA, Thompson DE, Ensrud KC, et al. Risk of mortality following clinical fractures. Osteoporos Int 2000; 11 (7): 556–61PubMedCrossRef
9.
Cooper C, Atkinson EJ, Jacobsen SJ, et al. Population-based study of survival after osteoporotic fractures. AmJ Epidemiol 1993; 137 (9): 1001–5
10.
Ensrud KE, Thompson DE, Cauley JA, et al. Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J Am Geriatr Soc 2000; 48 (3): 241–9PubMed
11.
Tosteson ANA. Quality of life in the economic evaluation of osteoporosis prevention and treatment. Spine 1997; 22 Suppl. 24: 58S–62SPubMedCrossRef
12.
Cook DJ, Guyatt GH, Adachi JD, et al. Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 1993; 36 (6): 750–6PubMedCrossRef
13.
Silverman SL, Mason J, Greenwald M. The Osteoporosis Assessment Questionnaire (OPAQ) — a reliable and valid self-assessment measure of quality-of-life in osteoporosis [abstract]. J Bone Miner Res 1993; 8: S343
14.
Lips P, Cooper C, Agnusdei D, et al. 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 1997; 7 (1): 36–8PubMedCrossRef
15.
Lydick E, Martin A, Yawn B. Impact of fears on quality of life in patients with a silent disease: osteoporosis. Clin Ther 1996; 18 (6): 1307–15PubMedCrossRef
16.
Helmes E, Hodsman A, Lazowski D, et al. A questionnaire to evaluate disability in osteoporotic patients with vertebral compression fractures. J Gerontol A Biol Sci Med Sci 1995; 50 (2): M91–8PubMedCrossRef
17.
Marquis P, Cialdella P, De la Loge C. Development and validation of a specific quality of life module in postmenopausal women with osteoporosis: the QUALIOST. Qual Life Res 2001; 10: 555–66PubMedCrossRef
18.
Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30 (6): 473–83PubMedCrossRef
19.
Bergner M, Bobbitt RA, Carter WB, et al. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981; 19 (8): 787–805PubMedCrossRef
20.
Cook DJ, Guyatt GH, Adachi JD, et al. Measuring quality of life in women with osteoporosis. Osteoporos Int 1997; 7 (5): 478–87CrossRef
21.
Cook DJ, Guyatt GH, Adachi JD, et al. Development and validation of the mini-osteoporosis quality of life questionnaire (OQLQ) in osteoporotic women with back pain due to vertebral fractures. Osteoporosis Quality of Life Study Group. Osteoporos Int 1999; 10 (3): 207–13PubMedCrossRef
22.
Kessenich CR, Guyatt GH, Rosen CJ. Health-related quality of life and participation in osteoporosis clinical trials. Calcif Tissue Int 1998; 62 (3): 189–92PubMedCrossRef
23.
Kessenich CR, Guyatt GH. Domains of health-related quality of life in elderly women with osteoporosis. J Gerontol Nurs 1998; 24 (11): 7–13PubMed
24.
Kerschan-Schindl K, Uher E, Preisinger E, et al. Translation of the Osteoporosis Quality of Life Questionnaire (OQLQ) into German. Wien Klin Wochenschr 1999; 111 (15): 608–11PubMed
25.
Badia X, Diez-Perez A, Alvarez-Sanz C, et al. Measuring quality of life in women with vertebral fractures due to osteoporosis: a comparison of the OQLQ and QUALEFFO. Qual Life Res 2001; 10: 307–17PubMedCrossRef
26.
Meenan RF, Mason JH, Anderson JJ, et al. AIMS 2 — the content and properties of a revised and expanded Arthritis Impact Measurement Scales health-status questionnaire. Arthritis Rheum 1992; 35 (1): 1–10PubMedCrossRef
27.
Randell AG, Nguyen TV, Bhalerao N, et al. Deterioration in quality of life following hip fracture: a prospective study. Osteoporos Int 2000; 11 (5): 460–6PubMedCrossRef
28.
Silverman SL. The Osteoporosis Assessment Questionnaire (OPAQ): a reliable and valid disease-targeted measure of health-related quality of life (HRQOL) in osteoporosis. Qual Life Res 2000; 9 (6): 767–74CrossRef
29.
Randell AG, Bhalerao N, Nguyen TV, et al. Quality of life in osteoporosis: reliability, consistency, and validity of the osteoporosis assessment questionnaire. J Rheumatol 1998; 25 (6): 1171–9PubMed
30.
Cantarelli FB, Szejnfeld VL, Oliveira LM, et al. Quality of life in patients with osteoporosis fractures: cultural adaptation, reliability and validity of the Osteoporosis Assessment Questionnaire. Clin Exp Rheumatol 1999; 17 (5): 547–51PubMed
31.
Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 1999; 282 (7): 637–45PubMedCrossRef
32.
Silverman SL, Minshall ME, Shen W, et al. The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 2001; 44: 2611–9PubMedCrossRef
33.
Dequeker J, Ranstam J, Valsson J, et al. The Mediterranean Osteoporosis (MEDOS) Study questionnaire. Clin Rheumatol 1991; 10 (1): 54–72PubMedCrossRef
34.
O’Neill TW, Cooper C, Cannata JB, et al. Reproducibility of a questionnaire on risk factors for osteoporosis in a multicentre prevalence survey: the European Vertebral Osteoporosis Study. Int J Epidemiol 1994; 23 (3): 559–65PubMedCrossRef
35.
Lips P, Cooper C, Agnusdei D, et al. Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int 1999; 10 (2): 150–60PubMedCrossRef
36.
Caulin F, Lips P, Cooper C, et al. 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 (QUALEFFO) [abstract]. Qual Life Res 1997; 6 (7–8): 58
37.
Hunt SM, McKenna SP, McEwen J, et al. A quantitative approach to perceived health status: a validation study. J Epidemiol Commun Health 1980; 34 (4): 281–6CrossRef
38.
Hunt SM, McKenna SP, Williams J. Reliability of a population survey tool for measuring perceived health problems: a study of patients with osteoarthrosis. J Epidemiol Commun Health 1981; 35 (4): 297–300CrossRef
39.
40.
The EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208CrossRef
41.
Oleksik A, Lips P, Dawson A, et al. Health-related quality of life in postmenopausal women with low BMD with orwithout prevalent vertebral fractures. J Bone Miner Res 2000; 15 (7): 1384–92PubMedCrossRef
42.
Oleksik AM, Ewing SK, Duong T, et al. Three years of health related quality of life assessment in postmenopausal women with osteoporosis: impact of incident vertebral fractures, age and severe adverse events. J Bone Miner Res 2000; 15: 1118
43.
Lydick E, Zimmerman SI, Yawn B, et al. Development and validation of a discriminative quality of life questionnaire for osteoporosis (the OPTQoL). J Bone Miner Res 1997; 12 (3): 456–63PubMedCrossRef
44.
Chandler JM, Martin AR, Girman C, et al. Reliability of an osteoporosis-targeted quality of life survey instrument for use in the community: OPTQoL. Osteoporos Int 1998; 8 (2): 127–35PubMedCrossRef
45.
Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychol Meas 1977; 1 (3): 385–401CrossRef
46.
Helmes E. Function and disability or quality of life? Issues illustrated by the Osteoporosis Functional Disability Questionnaire (OFDQ). Qual Life Res 2000; 9 (6): 755–61CrossRef
47.
Roland M, Morris R. A study of the natural-history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back-pain. Spine 1983; 8 (2): 141–4PubMedCrossRef
48.
Ettinger B, Black DM, Nevitt MC, et al. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 1992; 7 (4): 449–56PubMedCrossRef
49.
Ettinger B, Black DM, Palermo L, et al. Kyphosis in older women and its relation to back pain, disability and osteopenia: the study of osteoporotic fractures. Osteoporos Int 1994; 4 (1): 55–60PubMedCrossRef
50.
Nevitt MC, Ettinger B, Black DM, et al. The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 1998; 128 (10): 793–800PubMed
51.
Nevitt MC, Thompson DE, Black DM, et al. Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Arch Intern Med 2000; 160 (1): 77–85PubMedCrossRef
52.
Jette AM, Deniston OL. Inter-observer reliability of a functional status assessment instrument. J Chronic Dis 1978; 31 (9–10): 573–80PubMedCrossRef
53.
Jette AM. Functional Status Index: reliability of a chronic disease evaluation instrument. Arch Phys Med Rehabil 1980; 61 (9): 395–401PubMed
54.
Jette AM. The Functional Status Index: reliability and validity of a self-report functional disability measure. J Rheumatol 1987; 14: 15–9
55.
Lyles KW, Gold DT, Shipp KM, et al. Association of osteoporotic vertebral compression fractures with impaired functional status. Am J Med 1993; 94 (6): 595–601PubMedCrossRef
56.
Badia X, Prieto L, Roset M, et al. Development of a short osteoporosis quality of life questionnaire by equating items from two existing instruments. J Clin Epidemiol 2002; 55: 32–40PubMedCrossRef
57.
von Neumann J, Morgenstern O. Theory of games and economic behaviour. New York (NY): Wiley, 1944
58.
Torrance GW. Measurement of health state utilities for economic appraisal. J Health Econ 1986; 5 (1): 1–30PubMedCrossRef
59.
Tsevat J, Weeks JC, Guadagnoli E, et al. Using health-related quality-of-life information: clinical encounters, clinical trials, and health policy. J Gen Intern Med 1994; 9 (10): 576–82PubMedCrossRef
60.
Owens DK. Spine update: patient preferences and the development of practice guidelines. Spine 1998; 23 (9): 1073–9PubMedCrossRef
61.
Llewellyn-Thomas HA. Health state descriptions: purposes, issues, a proposal. Med Care 1996; 34 Suppl. 12: DS109–18PubMed
62.
Froberg D, Kane R. Methodology for measuring health-state preferences. II: scaling methods. J Clin Epidemiol 1989; 42 (5): 459–71PubMedCrossRef
63.
Froberg DG, Kane RL. Methodology for measuring health-state preferences. I: measurement strategies. J Clin Epidemiol 1989; 42 (4): 345–54PubMedCrossRef
64.
Froberg DG, Kane RL. Methodology for measuring health-state preferences. IV: progress and a research agenda. J Clin Epidemiol 1989; 42 (7): 675–85PubMedCrossRef
65.
Froberg DG, Kane RL. Methodology for measuring health-state preferences. III: population and context effects. J Clin Epidemiol 1989; 42 (6): 585–92PubMedCrossRef
66.
Cranney A, Coyle D, Pham BA, et al. The psychometric properties of patient preferences in osteoporosis. J Rheumatol 2001; 28 (1): 132–7PubMed
67.
Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making 2001; 21 (4): 329–34PubMed
68.
Torrance GW, Thomas WH, Sackett DL. A utility maximization model for evaluation of health care programs. Health Serv Res 1972; 7 (2): 118–33PubMed
69.
Gabriel SE, Kneeland TS, Melton LJ, et al. Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 1999; 19 (2): 141–8PubMedCrossRef
70.
Merlino LA, Bagchi I, Taylor TN, et al. Preferences for fractures and other glucocorticoid-associated adverse effects among rheumatoid arthritis patients. Med Decis Making 2001; 21 (2): 122–32PubMed
71.
Dolan P, Torgerson D, Kakarlapudi TK. Health-related quality of life of Colles’ fracture patients. Osteoporos Int 1999; 9 (3): 196–9PubMedCrossRef
72.
Salkeld G, Cameron ID, Cumming RG, et al. Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ 2000; 320 (7231): 341–6PubMedCrossRef
73.
Tosteson ANA, Gabriel SE, Grove MR, et al. Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos Int 2001; 12 (12): 1042–9PubMedCrossRef
74.
Brazier J, Dixon S. The use of condition specific outcome measures in economic appraisal. Health Econ 1995; 4 (4): 255–64PubMedCrossRef
75.
Brazier J, Deverill M. A checklist for judging preference-based measures of health related quality of life: learning from psychometrics. Health Econ 1999; 8 (1): 41–51PubMedCrossRef
76.
Gold MR, Siegel JE, Russell LB, et al. Cost-effectiveness in health and medicine. New York (NY): Oxford University Press, 1996
77.
Keeney RL, Raiffa H. Decisions with multiple objectives: preferences and value tradeoffs. New York (NY): Wiley, 1976
78.
Boyle M, Furlong W, Feeny D, et al. Reliability of the Health Utilities Index -Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual Life Res 1995; 4 (3): 249–57PubMedCrossRef
79.
Feeny D, Furlong W, Barr R, et al. A comprehensive multi-attribute system for classifying the health status of survivors of childhood cancer. J Clin Oncol 1992; 10 (6): 923–8PubMed
80.
Torrance G, Zhang Y, Feeny D, et al. Multi-attribute preference functions for a comprehensive health status classification system. Working paper series no. 92-18. Hamilton (ON): Centre for Health Economics and Policy Analysis, McMaster University (ON), 1992: 1–61
81.
Dolan P, Gudex C, Kind P, et al. The time trade-off method: results from a general population study. Health Econ 1996; 5: 141–54PubMedCrossRef
82.
83.
Anderson JP, Kaplan RM, Berry CC, et al. Interday reliability of function assessment for a health status measure. The Quality of Well-Being scale. Med Care 1989; 27 (11): 1076–83PubMedCrossRef
84.
Kaplan RM, Atkins CJ, Timms R. Validity of a quality of wellbeing scale as an outcome measure in chronic obstructive pulmonary disease. J Chronic Dis 1984; 37 (2): 85–95PubMedCrossRef
85.
Coons SJ, Rao S, Keininger DL, et al. A comparative review of generic quality-of-life instruments. Pharmacoeconomics 2000; 17 (1): 13–35PubMedCrossRef
86.
Brazier J, Usherwood T, Harper R, et al. Deriving a preference-based single index from the UK SF-36 Health Survey. J Clin Epidemiol 1998; 51 (11): 1115–28PubMedCrossRef
87.
Feeny D, Furlong W, Boyle M, et al. Multi-attribute health status classification systems. Health Utilities Index. Pharmacoeconomics 1995; 7 (6): 490–502PubMedCrossRef
88.
Torrance GW, Furlong W, Feeny D, et al. Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics 1995; 7 (6): 503–20PubMedCrossRef
89.
Tenenhouse A, Joseph L, Kreiger N, et al. Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the CanadianMulticentre Osteoporosis Study (CaMos). Osteoporos Int 2000; 11 (10): 897–904PubMedCrossRef
90.
Kaplan RM, Anderson JP. A general health policy model: update and applications. Health Serv Res 1988; 23 (2): 203–35PubMed
91.
Kaplan RM, Sieber WJ, Ganiats TG. The Quality of Well-Being Scale: comparison of the interview-administered version with a self-administered questionnaire. Psychol Health 1997; 12: 783–91CrossRef
92.
Fryback D, Lawrence W, Martin P, et al. Predicting quality of well-being scores from the SF-36: results from the Beaver Dam Health Outcomes Study. Med Decis Making 1997; 17 (1): 1–9PubMedCrossRef
93.
Cranney A, Welch V, Wells G, et al. Discrimination of changes in osteoporosis outcomes. J Rheumatol 2001; 28 (2): 413–21PubMed
Metadata
Title
Quality-of-Life Assessment in Osteoporosis
Health-Status and Preference-Based Measures
Authors
Dr Anna N. A. Tosteson
Cristina S. Hammond
Publication date
01-04-2002
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 5/2002
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200220050-00001

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