title: Cross-geographic region differences in quality of life in women with and without vertebral fracture.
abstract: CONCLUSIONS
  Not much is known about cross-geographic region differences in quality of life (QoL) in women with and without prevalent vertebral fractures (VFX). QoL differed between continents, countries, and ethnicities. The observed differences in QoL mostly appeared larger than the difference in QoL between women with or without mild to moderate VFX.
  
  
  BACKGROUND
  Quality of life (QoL) is an increasingly important outcome measure in randomized controlled trials and cost-utility studies. However, not much is known about cross-geographic region differences in QoL. The objective of this study was to describe the cross-geographic region differences in QoL in women with and without mild to moderate prevalent vertebral fractures (VFX).
  
  
  METHODS
  The study was performed using baseline data of the bazedoxifene study. The study was carried out in 25 countries in six continents (n = 7117). QoL was assessed using the index and Visual Analogue Scale (VAS) scores of the EQ-5D, Qualeffo-41, and Women's Health Questionnaire (WHQ). VFX were assessed using semi-quantitative and quantitative morphometric methods.
  
  
  RESULTS
  In general, all four instruments followed more or less the same pattern. In most analyses, the reported QoL was lowest in Asia and Europe and highest in North America and Oceania. To examine the influence of ethnicity, North and South America were stratified on race. In both continents, a lower QoL was observed in Hispanic people.
  
  
  CONCLUSIONS
  QoL differed between continents, countries, and ethnicities. The observed differences in QoL appeared larger between most continents and countries than the difference in QoL between women with or without mild to moderate VFX.
authors.affiliation: EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. nm.vanschoor@vumc.nl
authors.forename: N M
authors.initials: NM
authors.lastname: van Schoor
authors.forename: H
authors.initials: H
authors.lastname: Yu
authors.forename: J
authors.initials: J
authors.lastname: Bobula
authors.forename: P
authors.initials: P
authors.lastname: Lips
mesh_terms: D000368:Aged; D015992:Body Mass Index; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000208:ethnology / Q000517:prevention & control / Q000534:rehabilitation*; D011594:Psychometrics; D011788:Quality of Life; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D016103:Spinal Fractures / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation*
chemical_list: D050071:Bone Density Conservation Agents; D007211:Indoles; D020849:Raloxifene Hydrochloride; C447119:bazedoxifene