ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Transcultural adaptation and validation of the QUALEFFO-41 Questionnaire for Hebrew-Speaking Israeli women with postmenopausal osteoporosis with and without vertebral fractures.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
backgroundOsteoporosis 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.
methodsThe 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.
resultsThe 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).
conclusionThe 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.
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