ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2003
Contribution of clinical risk factors to bone density-based absolute fracture risk assessment in postmenopausal women.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk Assessment Tools for Osteoporosis Screening in Postmenopausal Women: A Systematic Review.Current osteoporosis reports · 2015Pooled it
- Vertebral anti-fracture efficacy of strontium ranelate according to pre-treatment bone turnover.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2010Pooled it
- Appropriate osteoporosis treatment by family physicians in response to FRAX vs CAROC reporting: results from a randomized controlled trial.Journal of clinical densitometry : the official journal of the International Society for Clinical DensitometryTrial
- Two-sample Mendelian randomization analysis evaluates causal associations between inflammatory bowel disease and osteoporosis.Frontiers in public health · 2023Article
- Relationship between bone mineral density and fragility fracture risk: a case-control study in Changsha, China.BMC musculoskeletal disorders · 2021Article
- FRAX®: prediction of major osteoporotic fractures in women from the general population: the OPUS study.PloS one · 2013Article
- Fracture prediction and calibration of a Canadian FRAX® tool: a population-based report from CaMos.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2011Article
- Development and validation of a population-based prediction scale for osteoporotic fracture in the region of Valencia, Spain: the ESOSVAL-R study.BMC public health · 2010Article
- Factors predicting osteoporosis treatment initiation in a regionally based cohort.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2009Article
- Association between change in BMD and fragility fracture in women and men.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2009Article
- Estimation of absolute fracture risk among middle-aged and older men and women: the EPIC-Norfolk population cohort study.European journal of epidemiology · 2009Article
- Risk factors for osteoporosis and fractures in postmenopausal women between 50 and 65 years of age in a primary care setting in Spain: a questionnaire.The open rheumatology journal · 2008Article
- T-plus Z-score in the assessment of relative fracture risk.Wiener medizinische Wochenschrift (1946) · 2007Article
- Validation of the Cummings' risk score; how well does it identify women with high risk of hip fracture: the Tromsø Study.European journal of epidemiology · 2006Article
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hip fractures are independently associated with advancing age, specific clinical risk factors (CRFs), and low bone mineral density (BMD). The use of BMD T-scores for quantifying fracture risk ignores the contribution of age and CRFs. We previously developed a mathematical model of absolute hip fracture risk that incorporates patient age, BMD, and the results of eleven specific CRFs. The purpose of this study was to compare the contribution of an approach to fracture risk stratification using the full model (age, CRFs and BMD) with that of a unidimensional BMD-only model. We selected 213 consecutive postmenopausal females (mean age 65.3, range 50-87.9) with CRF data referred for BMD assessment of fracture risk. Absolute hip fracture risk (over the next 5 years and remaining lifetime) was estimated using both the full and BMD-only models. The mean ratio of absolute hip fracture risks (BMD-only/full model) derived for each patient was 0.8 (95% CI, 0.16-4.0) for hip fracture in the next 5 years and 1.1 (CI, 0.1-7.6) for remaining lifetime. The wide confidence intervals indicate a large contribution of age and CRFs to fracture risk stratification. Categorization of women as "high risk" was frequently discordant for the two models. One-half of the women designated "high risk" under the full model were classified as "low risk" based upon BMD alone. In conclusion, we have shown that a multidimensional approach to hip fracture risk stratification is feasible, and greatly modifies risk stratification based on BMD alone.
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