Validation of the Malay version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) in Malaysia

Transcultural adaptation and validation of the QUALEFFO-41 Questionnaire for Hebrew-Speaking Israeli women with postmenopausal osteoporosis with and without vertebral fractures

To address cultural relevance in assessing osteoporosis-related quality of life, we validated and assessed the psychometric properties of the Hebrew version of QUALEFFO-41. The tool showed moderate reliability and validity, with diagnostic performance comparable to EQ-5D. This supports its clinical utility in Hebrew-speaking women with postmenopausal osteoporosis and vertebral fractures.

BACKGROUND

Osteoporosis and its associated vertebral fractures significantly impact the quality of life among postmenopausal women. The Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) is widely used to assess the quality of life in patients with osteoporotic spinal fractures but requires proper cultural adaptation for different populations.

PURPOSE

To translate, culturally adapt, and validate the QUALEFFO-41 questionnaire for Hebrew-speaking Israeli women with osteoporotic vertebral fractures (OVFs) and to compare its validity with the previously validated EQ-5D questionnaire in Israel.

METHODS

The study included 155 postmenopausal women aged 50-90 years: 49 with osteoporotic vertebral fractures (OVF group) and 106 with osteoporosis but no fractures (OPC group). The QUALEFFO-41 was translated following international guidelines and tested for reliability, validity, and sensitivity. Statistical analysis included internal consistency (Cronbach's alpha), test-retest reliability, discriminant and convergent validity, and ROC curve analysis.

RESULTS

The Hebrew QUALEFFO-41 demonstrated good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability. Most questions (90% in the OVF group and 97% in the OPC group) showed good to excellent correlations. Both QUALEFFO-41 and EQ-5D questionnaires showed sufficient sensitivity in diagnosing women with osteoporosis and fractures (AUC = 0.767 and 0.756, respectively).

CONCLUSION

The Hebrew version of QUALEFFO-41 demonstrates moderate reliability and validity properties for assessing quality of life in Israeli postmenopausal women with osteoporosis and vertebral fractures. The questionnaire shows satisfactory psychometric properties, though certain domains may benefit from further refinement.

Transcultural adaptation and psychometric properties of the Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)

We translated and adapted transculturally the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) for Korean patients. The translated Korean version of QUALEFFO-41 showed satisfactory reliability and validity.

PURPOSE

The aim of this study was to translate the QUALEFFO-41 for Korean patients and then validate the Korean version of QUALEFFO-41.

METHODS

Translation and transcultural adaptation of the QUALEFFO-41 was conducted according to the international recommendations. Ninety-seven patients (mean age, 73.6 years) with osteoporosis were participated in validating the Korean version of QUALEFFO-41. To test reliability, internal consistency was evaluated using Cronbach's alpha coefficient. To test validity, convergent validity was assessed using correlation with the SF-12 and EQ-5D and discriminant validity was assessed using ROC curve analysis.

RESULTS

The English version of QUALEFFO-41 was translated and adapted to Korean without notable discrepancies. The Korean QUALEFFO-41 had good reliability with Cronbach's alpha ranging from 0.733 to 0.942. QUALEFFO-41 had good correlations to SF-12 and EQ-5D. Compared with subjects without history of vertebral fracture (VF), those with history of VF showed significantly worse scores according to QUALEFFO-41, but not according to SF-12 or EQ-5D. ROC curve analysis revealed that the physical function domain of QUALEFFO-41 had significant ability to discriminate between subjects with and without history of VF, while SF-12 or EQ-5D did not.

CONCLUSIONS

The Korean version of QUALEFFO-41 demonstrated relevant internal consistency, convergent validity, and discriminant validity, which can be recommended to evaluate quality of life in Koreans.