Evidence map›Paper›PMID 17323110›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2007

The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women.

J A Kanis, A Oden, O Johnell, H Johansson, C De Laet, J Brown, P Burckhardt, C Cooper, C Christiansen, S Cummings and 19 more

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 517 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
517citing papers in PubMed, 9 pooled it
66.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

517 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,215 citations in OpenAlex.

  1. Predictive value of BMD for hip and other fractures: a meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Pooled it
  2. Forearm BMD predicts fracture independently of FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Pooled it
  3. Pooled it
  4. Guideline
  5. Guideline
  6. Guideline
  7. Pooled it
  8. Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Pooled it
  9. Guideline
  10. Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability-results from the Women's Health Initiative hormone therapy trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Trial
  11. Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Trial
  12. Trial
  13. The Effect of a Screening and Treatment Program for the Prevention of Fractures in Older Women: A Randomized Pragmatic Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2019
    Trial
  14. Review
  15. Review
  16. Article
  17. Observational
  18. Article
  19. Article
  20. Article

457 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors at 20 institutions in 12 countries.

J A KanisWHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.Pontefract@shef.ac.uk
A Oden
O Johnell
H Johansson
C De Laet
J Brown
P Burckhardt
C Cooper
C Christiansen
S Cummings
J A Eisman
S Fujiwara
C Glüer
D Goltzman
D Hans
M-A Krieg
A La Croix
E McCloskey
D Mellstrom
L J Melton
H Pols
J Reeve
K Sanders
A-M Schott
A Silman
D Torgerson
T van Staa
N B Watts
N Yoshimura
MRC Epidemiology Unit · GBUniversity Hospital of Lausanne · CHUniversity of Sheffield · GBCenter for Clinical & Basic Research · DKErasmus University Rotterdam · NLFred Hutch Cancer Center · USGarvan Institute of Medical Research · AUHospices Civils de Lyon · FRInstitut Scientifique de Santé Publique · BELund University · SEMayo Clinic in Arizona · USMcGill University · CARadiation Effects Research Foundation · JPThe Coordinating Center · USThe University of Tokyo · JPUniversity Hospital of Geneva · CHUniversity of Cincinnati Medical Center · USUniversity of Gothenburg · SEUniversity of Lübeck · DEUniversity of Melbourne · AU

Funding

Medical Research Council G0400491Medical Research Council MC_UP_A620_1014
6 · The paper itself

Abstract

unlabelledBMD and clinical risk factors predict hip and other osteoporotic fractures. The combination of clinical risk factors and BMD provide higher specificity and sensitivity than either alone. INTRODUCTION AND HYPOTHESES: To develop a risk assessment tool based on clinical risk factors (CRFs) with and without BMD.

methodsNine population-based studies were studied in which BMD and CRFs were documented at baseline. Poisson regression models were developed for hip fracture and other osteoporotic fractures, with and without hip BMD. Fracture risk was expressed as gradient of risk (GR, risk ratio/SD change in risk score).

resultsCRFs alone predicted hip fracture with a GR of 2.1/SD at the age of 50 years and decreased with age. The use of BMD alone provided a higher GR (3.7/SD), and was improved further with the combined use of CRFs and BMD (4.2/SD). For other osteoporotic fractures, the GRs were lower than for hip fracture. The GR with CRFs alone was 1.4/SD at the age of 50 years, similar to that provided by BMD (GR = 1.4/SD) and was not markedly increased by the combination (GR = 1.4/SD). The performance characteristics of clinical risk factors with and without BMD were validated in eleven independent population-based cohorts.

conclusionsThe models developed provide the basis for the integrated use of validated clinical risk factors in men and women to aid in fracture risk prediction.

Indexed as

AgedAged, 80 and overAge FactorsArea Under CurveBone DensityFemaleFractures, SpontaneousHip FracturesHumansMaleMiddle AgedOsteoporosisOsteoporosis, PostmenopausalRisk AssessmentRisk Factors

Identifiers

PMID17323110
OpenAlexW2139796029

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.