Evidence map›Paper›PMID 42117739›Full record

SynthesisAge and ageing2026

Health-related quality of life instruments for older persons with osteoporosis: a WHO-BOHEG systematic review of measurement properties for use in clinical trials and routine practice.

Clair M Gamble, Shaun Sabico, Germain Honvo, Salisu Abubakar, Jan R Boehnke, Stijn De Baets, Nicola Veronese, Veerle Knoop, Cyrus Cooper, Maria Luisa Brandi and 20 more

Abstract readSystematic Review
In one paragraph

Synthesis in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Clair M GambleSchool of Health Sciences, University of Dundee, Dundee DD1 4HJ, United Kingdom.
Shaun SabicoBiochemistry, King Saud University, Riyadh 11451, Saudi Arabia.ORCID 0000-0002-5248-2350
Germain HonvoConsultant to the Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, World Health Organization, Geneva 1211, Switzerland.ORCID 0000-0002-6992-6712
Salisu AbubakarSchool of Health Sciences, University of Dundee, Dundee DD1 4HJ, United Kingdom.
Jan R BoehnkeSchool of Health Sciences, University of Dundee, Dundee DD1 4HJ, United Kingdom.
Stijn De BaetsGhent University Faculty of Sciences, 9000 Ghent, Flanders, Belgium.
Nicola VeroneseDepartment of Internal Medicine,University of Palermo, Via del Vespro 133, 90127, Palermo, Sicily, Italy.
Veerle KnoopVrije Universiteit Brussel, Pleinlaan 21050 Elsene, Brussel, Belgium.ORCID 0000-0002-8308-4099
Cyrus CooperMRC Lifecourse Epidemiology Centre, University of Southampton, SO16 6YD Southampton, United Kingdom.ORCID 0000-0003-3510-0709
Maria Luisa BrandiDepartment of Endocrinology, Vita-Salute San Raffaele University, 20132 Milan, Lombardy, Italy.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit, University of Southampton, SO16 6YD Southampton, United Kingdom.ORCID 0000-0002-8194-2512
Radmila MatijevicFaculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Charlotte BeaudartBiomedical Sciences, University of Namur, B-5000 Namur, Belgium.
Rosemary NgoziDepartment of Radiation Medicine, University of Nigeria, Ihe Nsukka 410001, Nsukka, Enugu, Nigeria.
Tereza HoughNational Osteoporosis Foundation of South Africa (NOFSA), Durbanville 7550, South Africa.
Claudia CampusanoDepartment of Internal Medicine, Clínica Universidad de los Andes, Av Plaza 2501, Las Condes, Chile.
Marise Lazaretti-CastroMetabolic Bone and Mineral Diseases Research Center, Federal University of Sao Paulo, São Paulo, CEP 01246904, Brazil.
Manju ChandranDepartment of Endocrinology, Singapore General Hospital, Singapore 169608.
Ambrish MithalEndocrinology & Diabetes, Max Super Speciality Hospital, Dwarka, Delhi 110075, India.
Yousef Al-SalehDepartment of Medicine, Health Oasis Hospital, Riyadh 12451, Saudi Arabia.
Nasser Al-DaghriProtein Research Chair, Biochemistry Department, King Saud University, Riyadh 11451, Saudi Arabia.
Bess Dawson-HughesJean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, Massachusetts, USA.ORCID 0000-0003-3136-0386
Nansa BurletWHO Collaborating Centre for epidemiology of musculoskeletal health and ageing, University of Liege, 4000 Liège, Walloon Region, Belgium.
Etienne CavalierDepartment of Clinical Chemistry, University of Liege, 4000 Liège, Walloon Region, Belgium.
Eugene McCloskeyMellanby Centre for Bone Research, The University of Sheffield, S10 2RX Sheffield, United Kingdom.ORCID 0000-0003-0177-8140
Oliver BruyereDepartment of Public Health, Epidemiology and Health Economics, University of Liege, 4000 Liège, Walloon Region, Belgium.
Jean-Yves ReginsterWHO Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liege, 4000 Liège, Walloon Region, Belgium.
Theresa DiazDepartment of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva 1211, Switzerland.
René RizzoliDivision of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals, Geneva 1205, Switzerland.
Jotheeswaran Amuthavalli ThiyagarajanScience, Innovation, Monitoring Unit, Department of Sexual, Reproductive, Maternal, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, Geneva 1211, Switzerland.ORCID 0000-0001-7895-788X

Funding

European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)
6 · The paper itself

Abstract

backgroundOsteoporosis increases fracture risk in older adults and is associated with impaired health-related quality of life (HRQoL). Osteoporosis-specific HRQoL instruments are widely used, but their measurement performance in older populations has not been comprehensively synthesised.

objectiveTo systematically identify and synthesise development and validation studies of osteoporosis-specific HRQoL instruments for older adults, and to appraise their measurement properties using COSMIN criteria and a modified GRADE approach to inform instrument selection for clinical trials, routine care, and research.

designSystematic review.

settingCommunity-dwelling; Long-term care facility; Primary care facility. SUBJECTS: Older persons aged 60 years or over.

methodsWe searched Medline (Ovid), Embase, PsycINFO (Ovid), and AMED (Ovid) from inception to August 2024. We extracted and appraised evidence for COSMIN-defined measurement properties: content validity, structural validity, internal consistency, cross-cultural validity or measurement invariance, reliability, measurement error, criterion validity, hypothesis testing for construct validity, and responsiveness. Methodological quality was assessed using the COSMIN Risk of Bias checklist, measurement properties were rated against COSMIN criteria for good measurement properties, and certainty of evidence was graded using a modified GRADE approach.

resultsForty-three studies reported the development and/or validation of nine osteoporosis-specific HRQoL instruments; language and version adaptations resulted in 15 instrument variants. Content validity was the most prominent limitation: only OPTQoL and the English Mini-OQLQ demonstrated sufficient evidence for multiple content validity components, while most widely used instruments lacked adequate evidence on item relevance, comprehensiveness, or comprehensibility. Evidence for internal structure was limited, with structural validity sufficient for ECOS-16 and QoLOS-NVFX, insufficient for QUALEFFO-41, and indeterminate for most other instruments. Cross-cultural validity and measurement invariance were almost entirely unexamined. By contrast, reliability and hypothesis testing for construct validity were more consistently supported, often with moderate-to-high certainty. Measurement error, interpretability, and responsiveness were poorly reported across instruments.

conclusionsThe evidence base supports purpose-driven selection of osteoporosis-specific HRQoL instruments rather than a single preferred instrument. Across included studies, ECOS-16 shows the most consistently supported measurement properties in older adults for longitudinal assessment, although important evidence gaps remain (notably measurement error and cross-cultural validity). When brevity is the primary feasibility constraint in routine care, the Mini-OQLQ may be considered; however, evidence for responsiveness is limited.

Indexed as

OsteoporosisQuality of LifeAgedAged, 80 and overClinical Trials as TopicFemaleHumansMiddle AgedPsychometricsReproducibility of ResultsSurveys and Questionnairesageingmeasurement instrumentsolder personsosteoporosisquality of lifereliabilityresponsivenesssystematic reviewvalidity

Identifiers

PMID42117739
PMCPMC13162242

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.