0464 in the first and GSK2245840 research buy 0.0006 in the second year after the fracture [16]. However, the QALY loss in the second year could increase

to 0.30 in the case of dependency after the fracture according to the panel [16]. Thus, the QALY loss may depend on the age of the patient, the type of fracture and complications such as complex regional pain syndrome, all causing dependency of the patient on others. A similar variation was reported by the panel of the NOF regarding quality of life loss in the first year after vertebral fracture, ranging from 0.05 in a vertebral deformation to 0.50 QALY in a clinical fracture with severe pain [16]. Classification of vertebral fractures at diagnosis and a follow-up study on quality of life should be performed to better define the utility losses. The problem is that the onset of a vertebral deformity is often not known, selleck inhibitor as it may be asymptomatic.

Besides the new IOF instrument and the EQ-5D, other instruments have been used to assess recovery after wrist fracture. The disability of the arm, shoulder and hand (DASH) questionnaire, the patient-rated wrist evaluation (PRWE) and the short form 36 (SF-36) were combined with physical response measures in 59 patients with distal radius fracture [15]. In this study, the questionnaires were highly responsive in the first 3 months after the fracture when physical testing was not possible. The PRWE was more responsive than the DASH, and these two were more responsive than the SF-36, which is a generic quality of life instrument. The PRWE is a specific wrist questionnaire and the DASH is an upper limb questionnaire. Another analysis came to similar conclusions [17]. In our study, the specific IOF instrument was more responsive than the generic EQ-5D and the Qualeffo-41, which is a specific vertebral fracture questionnaire. Strengths of our study include the design of our questionnaire after focus group interviews,

the comparison with a generic instrument generating utility values and the longitudinal multicenter design. A limitation of our study is that the follow-up time points were not always strictly adhered at. However, when restricting the analysis to the subjects whose follow-up was within a strict time frame PI-1840 (e.g., 5–7 weeks for the 6-week time point), this did not change the results. Another weakness of our study is the fact that we did not compare our questionnaire with existing instruments such as DASH and PRWE. In addition, physical assessments such as handgrip strength were not done in our study. In conclusion, the IOF-wrist fracture questionnaire appears to be a reliable and responsive quality of life questionnaire, showing sufficient repeatability, high internal consistency and adequate sensitivity to change. It is ready for use in patients with wrist fracture, preferably in combination with Qualeffo-41 for overall evaluation of quality of life with regard to osteoporosis. check details Members of Working Group for Quality of Life M.L.