title: A conceptual and disease model framework for osteoporotic kyphosis.
abstract: This paper presents a multi-method research project to develop a conceptual framework for measuring outcomes in studies of osteoporotic kyphosis. The research involved literature research and qualitative interviews among clinicians who treat patients with kyphosis and among patients with the condition.
  
  
  BACKGROUND
  Kyphosis due to at least one vertebral compression fracture is prevalent among osteoporotic patients, resulting in well-documented symptoms and impact on functioning and well-being. A three-part study led to development of a conceptual measurement framework for comprehensive assessment of symptoms, impact, and treatment benefit for kyphosis.
  
  
  METHODS
  A literature-based disease model (DM) was developed and tested with physicians (n = 10) and patients (n = 10), and FDA guidelines were used to develop a final disease model and a conceptual framework.
  
  
  RESULTS
  The DM included signs, symptoms, causes/triggers, exacerbations, and functional status associated with kyphosis. The DM was largely confirmed, but physicians and patients added several concepts related to impact on functioning, and some concepts were not confirmed and removed from the DM.
  
  
  CONCLUSIONS
  This study confirms the need for more comprehensive assessment of health outcomes in kyphosis, as most current studies omit key concepts.
authors.affiliation: QualityMetric, OptumInsight, 34 Albion Road, Bldg 400, Lincoln, RI 02865, USA. mbayliss@qualitymetric.com
authors.forename: M
authors.initials: M
authors.lastname: Bayliss
authors.forename: C
authors.initials: C
authors.lastname: Miltenburger
authors.forename: M
authors.initials: M
authors.lastname: White
authors.forename: L
authors.initials: L
authors.lastname: Alvares
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D008954:Models, Biological; D010024:Osteoporosis / Q000150:complications; D058866:Osteoporotic Fractures / Q000150:complications*; D017063:Outcome Assessment, Health Care / Q000379:methods; D017410:Practice Guidelines as Topic; D016103:Spinal Fractures / Q000150:complications*
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