Qualeffo-41
LASAeo00
LASAeo01
LASAeo02
Jan Poppelaars , Natasja van Schoor
Date of last revision: 12-03-2009
Background
To measure quality of life in persons with vertebral compression fractures the Qualeffo-41 was assessed in a subpopulation of the LASA-study. The Qualeffo-41 was developed by the Working Party of the European Foundation for Osteoporosis (including Paul Lips) and the first results were presented in 1997.(1) The Qualeffo-41 is a specific quality of life instrument, which is developed for patients with vertebral compression fractures.2 Vertebral compression fracture are a consequence of osteoporosis and influence functioning and quality of life.3,4 The development and validation of Qualeffo-41 are described in refs 1,2, 5.
Instrument
The questionnaire consists of 41 items and includes five domains: (A) pain; (B, C, D) physical function; (E) social function; (F) general health perception and (G) mental function.
Domain scores and total score are calculated as follows:
- All answers were standardized so that 1 represents the best.
- Answers with 3 and 4 answer options (disregard “not applicable”) were recoded, so that all variables have a range 1-5.
- Domain scores and total score were calculated by averaging all answers and transforming them to a 0-100 scale.
Enclosed is a syntax with the scoring algorithm which is developed by Paul Lips and Cyrus Cooper. The scoring algorithm is also shortly described in the validation study 5 and is available on request at Paul Lips (p.lips@vumc.nl). Also, two alternative scoring logarithms, as used by Oleksik 4, were described below.
Measurement in LASA
The data on the Qualeffo-41 are obtained in 2000/2001 by a self-administered questionnaire in patients who had 2 valid spinographs in 1995/1996 and 1998/1999 (n=339). Of these, 26 persons were deceased, 22 refused and 24 were ineligible. The response rate, after subtraction of the persons who deceased, was 267 / (339-26) = 85.3%.
LASAeo00 includes the response rate.
LASAeo01 includes the item scores (including 2 items belonging to the pain drawing)
LASAeo02 includes the domain scores, the total score and the number of item missing values per domain and for the total questionnaire. Both the domain scores and the total score can be used in the analyses.
Previous use in LASA
Van Schoor NM, Knol DL, Glas CA, Ostelo RW, Leplège A, Cooper C, Johnell O, Lips P. Development of the Qualeffo-31, an osteoporosis-specific quality-of-life questionnaire. Osteoporos Int. 2006;17(4):543-51.
Van Schoor NM, Smit JH, Twisk JW, Lips P. Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporos Int. 2005 Jul;16(7):749-56. Epub 2004 Oct 12.
Reference List
1. 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;7:36-8.
2. Lips P, Agnusdei D, Caulin F, et al. The development of a European questionnaire for quality of life in patients with vertebral osteoporosis. Scand J Rheumatol Suppl. 1996;103:84-5; discussion 86-8.
3. Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P. Consequences of vertebral deformities in older men and women. J Bone Miner Res. 2000;15:1564-72.
4. Oleksik A, Lips P, Dawson A, et al. Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res. 2000;15:1384-92.
5. 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). Osteoporos Int. 1999;10:150-60.
6. Van Schoor NM, Knol DL, Glas CA, Ostelo RW, Leplège A, Cooper C, Johnell O, Lips P. Development of the Qualeffo-31, an osteoporosis-specific quality-of-life questionnaire. Osteoporos Int. 2006;17(4):543-51.
Syntax with scoring algorithm
set list 'eo02.lis'.
* scoring algoritme Qualeffo volgens Lips & Cooper.
get file 'lasaeo01.sys'.
* 1. All answers are standardized so that 1 represents the best.
* and 5 (or 3, or 4) represents the worst quality of life:.
* reverse scores on questions 33, 34, 35, 37, 39, 40.
reco eoqual33 eoqual34 eoqual35 eoqual37 eoqual39 eoqual40
(1=5) (2=4) (3=3) (4=2) (5=1).
* 2. recode answers of questions with 3 answer options (23-26):
* disregard "not applicable" (question 24) and "no cinema" (question 26).
* - score 1 -> 1, 2 -> 3, 3 -> 5.
reco eoqual24 eoqual26 (4=-1).
reco eoqual23 eoqual24 eoqual25 eoqual26 (1=1) (2=3) (3=5).
* 3. Answers of questions with 4 answer options (27-28):.
* - score 1 -> 1, 2 -> 2.3, 3 -> 3.6, 4 -> 5.
* disregard "not applicable" (question 29).
reco eoqual29 (5=-1).
reco eoqual27 eoqual28 eoqual29 (1=1) (2=2.3) (3=3.6) (4=5).
* 4. calculation of means of domains.
* NB: bij pijn hadden volgens Paul alle vragen aan iedereen gesteld.
* moeten worden. Als eoqual01=1, dan zijn andere pijnvragen ook 1.
if (eoqual01=1) eoqual02=1.
if (eoqual01=1) eoqual03=1.
if (eoqual01=1) eoqual04=1.
if (eoqual01=1) eoqual05=1.
* tussentijdse opslag voor later gebruik.
save file 'tempitem.sys' /comp.
get file 'tempitem.sys'.
* 4A. Pain (5 items).
reco eoqual01 to eoqual05 (-2=-1).
coun misa=eoqual01 to eoqual05 (-1).
reco eoqual01 to eoqual05 (-1=0).
comp eoqualat=eoqual01+eoqual02+eoqual03+eoqual04+eoqual05.
comp eoquala=eoqualat/(5-misa).
comp eoquala=(eoquala-1)*25.
if (misa>1) eoquala=-2.
* 4B, 4C en 4D vormen samen het domein physical function.
*NB: Navragen bij Paul of dit inderdaad alleen als 1 domein gezien moet worden.
*NB: Alle afkappunten voor missing values controleren met Paul.
* Vervangen door:.
* 4B, C, D. physical function (17 items).
coun misb=eoqual06 to eoqual22 (-1).
reco eoqual06 to eoqual22 (-1=0).
comp eoqualbt=eoqual06+eoqual07+eoqual08+eoqual09+eoqual10+eoqual11+eoqual12
+eoqual13+eoqual14+eoqual15+eoqual16+eoqual17+eoqual18+eoqual19+eoqual20
+eoqual21+eoqual22.
comp eoqualb=eoqualbt/(17-misb).
comp eoqualb=(eoqualb-1)*25.
if (misb>5) eoqualb=-2.
* 4E. Leisure and social activities (7 items).
coun mise=eoqual23 to eoqual29 (-1).
reco eoqual23 to eoqual29 (-1=0).
comp eoqualet=eoqual23+eoqual24+eoqual25+eoqual26+eoqual27+eoqual28+eoqual29.
comp eoquale=eoqualet/(7-mise).
comp eoquale=(eoquale-1)*25.
if (mise>2) eoquale=-2.
* 4F. Views about health in general (3 items).
coun misf=eoqual30 to eoqual32 (-1).
reco eoqual30 to eoqual32 (-1=0).
comp eoqualft=eoqual30+eoqual31+eoqual32.
comp eoqualf=eoqualft/(3-misf).
comp eoqualf=(eoqualf-1)*25.
if (misf>0) eoqualf=-2.
* 4G. Mood (9 items).
coun misg=eoqual33 to eoqual41 (-1).
reco eoqual33 to eoqual41 (-1=0).
comp eoqualgt=eoqual33+eoqual34+eoqual35+eoqual36+eoqual37+
eoqual38+eoqual39+eoqual40+eoqual41.
comp eoqualg=eoqualgt/(9-misg).
comp eoqualg=(eoqualg-1)*25.
if (misg>2) eoqualg=-2.
save file 'temp1.sys' /keep respnr misa eoquala misb eoqualb
mise eoquale misf eoqualf misg eoqualg /comp.
get file 'tempitem.sys'.
* 5. The totalscore is calculated by summing all answers of questions 1-41.
* The raw total score ranges from 41 to 205 (or less when some answers.
* are missing) and this is transformed to scores from 0 to 100.
reco eoqual01 to eoqual05 (-2=-1).
coun mis=eoqual01 to eoqual41 (-1).
format mis (f2).
reco eoqual01 to eoqual41 (-1=0).
comp eoqualat=eoqual01+eoqual02+eoqual03+eoqual04+eoqual05.
comp eoqualbt=eoqual06+eoqual07+eoqual08+eoqual09+eoqual10+eoqual11+eoqual12
+eoqual13+eoqual14+eoqual15+eoqual16+eoqual17+eoqual18+eoqual19+
eoqual20+eoqual21+eoqual22.
comp eoqualet=eoqual23+eoqual24+eoqual25+eoqual26+eoqual27+eoqual28+eoqual29.
comp eoqualft=eoqual30+eoqual31+eoqual32.
comp eoqualgt=eoqual33+eoqual34+eoqual35+eoqual36+eoqual37+
eoqual38+eoqual39+eoqual40+eoqual41.
comp eoqualt=eoqualat+eoqualbt+eoqualet+eoqualft+eoqualgt.
comp eoqual=eoqualt/(41-mis).
* standaardiseren score van 1-5 naar 0-100.
comp eoqual=(eoqual-1)*25.
if (mis>12) eoqual=-2.
** vergelijk met formule Lips (= precies dezelfde).
comp eoqualpl=((eoqualt-(41-mis))/((41-mis)*4))*100.
if (mis>12) eoqualpl=-2.
* vergelijk scores.
comp delta=eoqual-eoqualpl.
fre delta.
save file 'temp2.sys' /keep respnr mis eoqual /comp.
* scoring algoritme Qualeffo volgens Oleksik.
* Response options for each item were standardised, so that option 1.
* corresponded to the least impact on HRQOL and option 5 to the greatest.
* impact (=1, 2 and 3 Lips & Cooper).
* If at least one half of the items in the domain were answered,.
* the domain scores were calculated by averaging the non-missing scores.
* for individual questions within a domain.
* Doing this, we have assumed that the mean of missing scores would be equal.
* to the mean of the non-missing scores (imputation). (according to Lips.
* & Cooper domain & total scores become questionable at >= 30% missing values).
* The domain scores were then linearly transformed to a 100-point scale.
* with 0 corresponding to the best HRQOL and 100 to the worst HRQOL.
* (=4 Lips & Cooper).
* The QUALEFFO total score was calculated in two ways:.
* 1) as the average of transformed domain scores.
* 2) as the average of scores for all non-missing individual questions.
* This score was calculated only if at least 50%.
* of all items were answered (Lips & Cooper: sum of individual items).
get file 'tempitem.sys'.
* 4A. Pain (5 items).
reco eoqual01 to eoqual05 (-2=-1).
coun misa=eoqual01 to eoqual05 (-1).
reco eoqual01 to eoqual05 (-1=0).
comp eoqualat=eoqual01+eoqual02+eoqual03+eoqual04+eoqual05.
comp eoquala2=eoqualat/(5-misa).
comp eoquala2=(eoquala2-1)*25.
if (misa>2) eoquala2=-2.
* 4B, C, D. physical function (17 items).
coun misb=eoqual06 to eoqual22 (-1).
reco eoqual06 to eoqual22 (-1=0).
comp eoqualbt=eoqual06+eoqual07+eoqual08+eoqual09+eoqual10+eoqual11+eoqual12
+eoqual13+eoqual14+eoqual15+eoqual16+eoqual17+eoqual18+eoqual19+eoqual20
+eoqual21+eoqual22.
comp eoqualb2=eoqualbt/(17-misb).
comp eoqualb2=(eoqualb2-1)*25.
if (misb>8) eoqualb2=-2.
* 4E. Leisure and social activities (7 items).
coun mise=eoqual23 to eoqual29 (-1).
reco eoqual23 to eoqual29 (-1=0).
comp eoqualet=eoqual23+eoqual24+eoqual25+eoqual26+eoqual27+eoqual28+eoqual29.
comp eoquale2=eoqualet/(7-mise).
comp eoquale2=(eoquale2-1)*25.
if (mise>3) eoquale2=-2.
* 4F. Views about health in general (3 items).
coun misf=eoqual30 to eoqual32 (-1).
reco eoqual30 to eoqual32 (-1=0).
comp eoqualft=eoqual30+eoqual31+eoqual32.
comp eoqualf2=eoqualft/(3-misf).
comp eoqualf2=(eoqualf2-1)*25.
if (misf>1) eoqualf2=-2.
* 4G. Mood (9 items).
coun misg=eoqual33 to eoqual41 (-1).
reco eoqual33 to eoqual41 (-1=0).
comp eoqualgt=eoqual33+eoqual34+eoqual35+eoqual36+eoqual37+
eoqual38+eoqual39+eoqual40+eoqual41.
comp eoqualg2=eoqualgt/(9-misg).
comp eoqualg2=(eoqualg2-1)*25.
if (misg>4) eoqualg2=-2.
* Total score qualeffo Oleksik 1: eoqualo1.
coun miso1=eoquala2 eoqualb2 eoquale2 eoqualf2 eoqualg2 (-2).
reco eoquala2 eoqualb2 eoquale2 eoqualf2 eoqualg2 (-2=0).
comp eoquao1t=eoquala2+eoqualb2+eoquale2+eoqualf2+eoqualg2.
comp eoqualo1=eoquao1t/(5-miso1).
if (miso1>2) eoqualo1=-2.
save file 'temp3.sys' /keep respnr eoquala2 eoqualb2
eoquale2 eoqualf2 eoqualg2 eoqualo1 /comp.
get file 'tempitem.sys'.
* Total score qualeffo Oleksik 2: eoqualo2
reco eoqual01 to eoqual05 (-2=-1).
coun miso2=eoqual01 to eoqual41 (-1).
format miso2 (f2).
reco eoqual01 to eoqual41 (-1=0).
comp eoqualat=eoqual01+eoqual02+eoqual03+eoqual04+eoqual05.
comp eoqualbt=eoqual06+eoqual07+eoqual08+eoqual09+eoqual10+eoqual11+eoqual12
+eoqual13+eoqual14+eoqual15+eoqual16+eoqual17+eoqual18+eoqual19+
eoqual20+eoqual21+eoqual22.
comp eoqualet=eoqual23+eoqual24+eoqual25+eoqual26+eoqual27+eoqual28+eoqual29.
comp eoqualft=eoqual30+eoqual31+eoqual32.
comp eoqualgt=eoqual33+eoqual34+eoqual35+eoqual36+eoqual37+
eoqual38+eoqual39+eoqual40+eoqual41.
comp eoqualt=eoqualat+eoqualbt+eoqualet+eoqualft+eoqualgt.
comp eoqualo2=eoqualt/(41-miso2).
comp eoqualo2=(eoqualo2-1)*25.
if (miso2>20) eoqualo2=-2.
save file 'temp4.sys' /keep respnr eoqualo2 /comp.
join match /file 'temp1.sys'
/file 'temp2.sys'
/file 'temp3.sys'
/file 'temp4.sys'
/by respnr.
format misa misb mise misf misg mis (f2).
VAR LABELS
eoquala 'Score pain' /
eoqualb 'Physical function' /
eoquale 'Score leisure and social activities' /
eoqualf 'Score views about health in general' /
eoqualg 'Score mood'/
eoquala2 'Score pain (#mis<50%)' /
eoqualb2 'Physical function (#mis<50%)' /
eoquale2 'Score leisure and social activities (#mis<50%)' /
eoqualf2 'Score views about health in general (#mis<50%)' /
eoqualg2 'Score mood (#mis<50%)' /
eoqual 'Total score Qualeffo'/
eoqualo1 'Total score Qualeffo (method 2)'/
eoqualo2 'Total score Qualeffo (method 3)'/
misa '# missings pain' /
misb '# missings physical function' /
mise '# missings leisure and social activities' /
misf '# missings views about health in general' /
misg '# missings mood' /
mis '# missings total score qualeffo'.
save file 'lasaeo02.sys' /comp.
set list 'lasaeo02.lis'.
get file 'lasaeo02.sys'.
fre misa to eoqualo2.
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