On conducting burden-of-osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center

Osteoporosis is a problem that is relevant to public health from the clinic al, economic and social viewpoints. Except in a handful of industrialized c ountries, there is a considerable void in our knowledge of the magnitude of the problem. By exploring both the epidemiological and the economic impact of osteoporosis and the fractures associated with it in a particular count ry, studies of the 'burden of illness' (BOI) can fill that void. BOI analys is raises many questions at both the conceptual and the practical level. Th e purpose of this paper is to review the methodology underlying analyses of this type, to discuss its limitations and to provide a general format to i mprove their implementation in the field of osteoporosis. Investigators inv olved in BOI analysis should be very clear and explicit regarding the metho ds they adopt, so that studies in different countries call be interpreted a nd compared appropriately by interested parties.