Osteoporotic vertebral fractures are common in older women: 12% of women over aged 65 have at least one vertebral deformity, the majority of which are osteoporotic in origin. Quantitative morphometric approaches define vertebral fractures as mild (20-25% height reduction), moderate (25-40% height reduction) or severe (>40% height reduction). There is increasing interest in looking at the predictors and impact of mild versus moderate/severe vertebral fractures, as it is increasingly recognised that there may be different underlying reasons for these fractures, specifically degenerative change causing mild fractures and osteoporosis causing moderate/severe fractures. Understanding the characteristics of back pain associated with mild fractures compared to that associated with moderate/severe fractures will increase our understanding of the differences between these types of fractures.
The aim of this PhD is to examined the characteristics and impact of back pain associated with mild vertebral fractures compared to those associated with moderate/severe fractures using mixed quantitative and qualitative methods. The specific aims of this PhD are (1) To systematically review the literature to identify what is already known about back pain in older women in general, and more specifically in those with vertebral fractures; (2) To utilise data already collected in the Vfrac study to describe the pattern of back pain using a quantitative approach; (3) To undertake a new qualitative study on the impact of the different types of vertebral fractures in a sample of older women.
Outcomes of this PhD will be (1) To learn transferable research skills in systematic literature reviewing and meta-analysis, cohort study design, statistical analysis including linear and logistic multivariable regression, how to deal with missing data, qualitative research techniques and scientific communication including oral and verbal presentations plus paper writing. Software use includes Stata and NVivo; (2) To receive formal training in epidemiology, statistical analysis, ICH-GCP, IRAS, and qualitative methodology; (3) To publish at two to six papers from this PhD, and present the findings at local, national and international research meetings.