Abstract
OBJECTIVE: This article describes the development and validation of the osteoporosis treatment questionnaire (OSTREQ), which is a physician-reported outcome tool aiming to evaluate physicians’ criteria in the choice of osteoporosis treatment. DESIGN: The questionnaire -named OSTREQ- consisting of 17 questions that were divided into eight sections “Health Care System”, “Patients’ Preference in administration routes”, “Usage, Cost”, “Severity of Disease”, “Treatment Efficacy”, “Safety Profile”, “Pharmaceutical Industry”, affecting the decision and overall execution of a therapeutic approach, was developed by an expert panel and was later officially translated into English. In the second phase, orthopedic surgeons were asked to complete OSTREQ. Six indirect methods to evaluate validity were adopted: exploratory factor analysis, confirmatory factor analysis, subscale validity, known group validity, floor or ceiling effects, interpretability. To assess the reliability of the questionnaire, internal consistency validity as well as test-retest and parallel forms were calculated. RESULTS: One hundred seventy-two orthopedic surgeons were interviewed with an average period of experience in clinical practice of 10.5 years (SD ±8.9 years). The factors “Severity of Disease” and “Treatment Efficacy” were the most important in the choice of osteoporosis treatment, while the factor “Pharmaceutical Industry” had the least impact. The methodology of validation proved that the questionnaire possesses construct validity, discriminate ability, reliability, and sensitivity to change. CONCLUSIONS: OSTREQ represents a comprehensive and focused tool that, for the first time, assesses physicians’ criteria in the choice of osteoporosis treatment. This tool could assist health care systems and pharmaceutical companies to be aware which parameters drive physicians’ preferences regarding osteoporosis treatment.
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Hernlund E, Svedbom A, Ivergard M, et al, 2013 Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8: 136.
Svedbom A, Hernlund E, Ivergard M, et al, 2013 Epidemiology and economic burden of osteoporosis in Greece. Arch Osteoporos 8: 83–90.
Siris ES, Miller PD, Barrett-Connor E, et al, 2001 Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286: 2815–2822.
Kanis JA, Johnell O, Oden A, et al, 2000 Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27: 585–590.
WHO Fracture Risk Assessment Tool. http://www.shef.ac.uk/FRAX/?lang=en. Accessed 7 November 2015.
Makras P, Vaiopoulos G, Lyritis GP, Greek National Medicine A, 2012 2011 guidelines for the diagnosis and treatment of osteoporosis in Greece. J Musculoskelet Neuronal Interact 12: 38–42.
Makras P, Athanasakis K, Boubouchairopoulou N, et al, 2015 Cost-effective osteoporosis treatment thresholds in Greece. Osteoporos Int 26: 1949–1957.
Lecart MP, Reginster JY, 2011 Current options for the management of postmenopausal osteoporosis. Expert Opin Pharmacother 12: 2533–2552.
Lawshe C, 1975 A quantitative approach to content validity. Personnel Psychology 28: 563–575.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB, 2000 Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25: 3186–3191.
Gorgush RL 1978 Psychometric Theory. USA: McGraw-Hill.
Harman HH 1967 Modern Factor Analysis. Chicago: University of Chicago Press.
Arbuckle JL 2006 AMOS 7.0 user’s guide. Chicago, IL.
Fabrigar LR, Wegener DT, Mac Callum RC, Strahan EJ, 1999 Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods 4: 272–299.
Guadagnoli E, Velicer WF, 1988 Relation to sample size to the stability of component patterns. Psychological Bulletin 103: 265–275.
Hu L, Bentier PM, 1999 Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modelling 6: 1–55.
Byrne BM 1989 A primer of LISREL: Basic applications and programming for confirmatory analytic models. New York: Springer-Verlag.
Mc Donald RP, Marsh HW, 1990 Choosing a multivariate model: noncentrality and goodness of fit Psychological Bulletin 107: 247–255.
Bollen KA 1989 Structural equations with latent variables. New York: John Wiley & Sons.
McHorney CA, Tarlov AR, 1995 Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4: 293–307.
Cronbach LJ, 1951 Coefficient alpha and the internal structure of test. Psychometrica 16: 297–334.
Higgins PA, Straub AJ, 2006 Understanding the error of our ways: mapping the concepts of validity and reliability. Nurs Outlook 54: 23–29.
Bland JM, Altman DG, 2002 Statistics Notes: Validating scales and indexes. BMJ 324: 606–607.
Boynton PM, 2004 Administering, analysing, and reporting your questionnaire. BMJ 328: 1372–1375.
Brink TL 2004 Questionnaires. Practical hints on how to avoid mistakes in design and interpretation. Chesterfield: Heuristic Books.
Koh LK, Sedrine WB, Torralba TP, et al, 2001 A simple tool to identify asian women at increased risk of osteoporosis. Osteoporos Int 12: 699–705.
McDonough CM, Grove MR, Elledge AD, Tosteson AN, 2012 Predicting EQ-5D-US and SF-6D societal health state values from the Osteoporosis Assessment Questionnaire. Osteoporos Int 23: 723–732.
Naegeli AN, Nixon A, Burge R, et al, 2014 Development of the Osteoporosis Assessment Questionnaire—physical Function (OPAQ-PF): an osteoporosis-targeted, patient-reported outcomes (PRO) measure of physical function. Osteoporos Int 25: 579–588.
Gold DT, Home R, Coon CD, et al, 2011 Development, reliability, and validity of a new Preference and Satisfaction Questionnaire. Value Health 14: 1109–1116.
Freemantle N, Satram-Hoang S, Tang ET, et al, 2012 Final results of the DAPS (Denosumab Adherence Preference Satisfaction) study: a 24-month, randomized, crossover comparison with alendronate in postmenopausal women. Osteoporos Int 23: 317–326.
Hadji P, Ziller V, Gamerdinger D, et al, 2012 Quality of life and health status with zoledronic acid and generic alendronate—a secondary analysis of the Rapid Onset and Sustained Efficacy (ROSE) study in postmenopausal women with low bone mass. Osteoporos Int 23: 2043–2051.
Lee S, Glendenning P, Inderjeeth CA, 2011 Efficacy, side effects and route of administration are more important than frequency of dosing of anti-osteoporosis treatments in determining patient adherence: a critical review of published articles from 1970 to 2009. Osteoporos Int 22: 741–753.
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Makras, P., Galanos, A., Rizou, S. et al. Development and validation of an osteoporosis treatment questionnaire (OSTREQ) evaluating physicians’ criteria in the choice of treatment. Hormones 15, 413–422 (2016). https://doi.org/10.14310/horm.2002.1684
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DOI: https://doi.org/10.14310/horm.2002.1684