Quality of Life for Osteoporosis (Qualeffo)
The Quality of Life Questionnaire (QUALEFFO-41) is developed by the International Osteoporosis Foundation (IOF) and measures the changes in everyday functioning, wellbeing and health related quality of life in patients with vertebral fractures. The questionnaire includes questions in the domains pain, physical function, social function, general health perception and mental health function. The QUALEFFO-41 score decreases with increasing number of vertebral fractures.
Individuals with vertebral fractures as a result of osteoporosis.
Method of Use
The questionnaire is currently available in the following languages: English, English US, Bulgarian, Czech, Danish, Dutch, Finnish, French, German, Greek, Hungarian, Italian, Korean, Polish, Portuguese, Portuguese Brazil, Romanian, Russian, Spanish, Spanish Argentina, Spanish Chile, Spanish Mexico, Spanish US, Swedish and Thai.
The patient fills out the entire questionnaire, which measures quality of life on 5 domains (pain, activities of daily living, jobs around the house, mobility, leisure/ social activities, general health perception and mental function). The therapist then uses the scoring algorithm to a total score.
Individuals with a vertebral fracture will score lower on the questionnaire than healthy individuals of the same age and gender.
- Internal consistency - Cronbach’s alpha (adequate) N= 159, P= patients with a vertebral fracture as a result of osteoporosis: 0.801 - Cronbach’s alpha N=304, P= females with degenerative changes due to osteoporosis : 0.63-0.906
- Reliability of de questionnaire in patients with osteoporosis and at least one vertebral fracture is good: - N=159, P= patients with a vertebral fracture as a result of osteoporosis: kappa 0.54-0.90 (26 out of 41 questions kappa-score >/=0.70) - ICC, N=304, P=females with degenerative changes due to osteoporosis: 0.80-0.93 - Test-retest reliability of most QUALEFFO-items was good, N=171, P=males and females (population sample): kappa 0.59-0.91 
- Correlation validity - QUALEFFO vs. SF-36 domains, N= 171, P= males and females (population sample): r = 0.57 to r = 0.87 - QUALEFFO vs. GHQ-20, N= 89, P= females: r = 0.49
- Construct validity - The QUALEFFO has a good correlation with the SF-36.
- Discriminant validity - The QUALEFFO can distinguish between patients with a vertebral fracture and control group (x-ray vs. QUALEFFO, N=159, P=patients with a vertebral fracture: 78% had a fracture (>/=3 SD), in comparison to 7% from the control group - The score on the QUALEFFO was 49.8 +/- 19.2 in patients with osteopenia and significantly higher with patients with osteoporosis without vertebral fracture (avg. 58.1 +/- 13.3; p <0.05). In patients with osteoporosis with a previous vertebral fracture, the average score was also significantly higher (63.8 +/- 13.6 (p < 0.05)).
- QUALEFFO-scores increase progressively if the individual has one or more vertebral fractures (especially lumbal): (p < 0.001)
- Patients with a vertebral fracture have a significant score change on the QUALEFFO: (p < 0.05)
- QUALEFFO-scores change in relation to the number of fractures a patient has
- QUALEFFO-41: Effect size (ES) = 2.56, standardised response mean (SRM) = 4.32 and Guyatt value = 2.31
- Quality of Life Questionnaires at the International Osteoporosis Foundation (all languages)
- Quality of Life Questionnaire (English)
- QUALEFFO-41 scoring algorithm
- Osteoporosis on Physiopedia
- Osteoporotic Vertebral Fractures on Physiopedia
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