SynthesisCalcified tissue international2014
Impact of femoral neck and lumbar spine BMD discordances on FRAX probabilities in women: a meta-analysis of international cohorts.
Synthesis in Calcified tissue international, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
31 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Guidelines for fracture risk assessment and management of osteoporosis in postmenopausal women and men above the age of 50 in Qatar.Archives of osteoporosis · 2024Guideline
- 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 · 2022Pooled it
- UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2022Guideline
- European guidance for the diagnosis and management of osteoporosis in postmenopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Guideline
- A systematic review of intervention thresholds based on FRAX : A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation.Archives of osteoporosis · 2016Pooled it
- Impact of FRAXplus adjustments vs FRAX on fracture risk classification in the Swiss Osteoporosis Registry.JBMR plus · 2026Article
- Spine-hip bone mineral density discordance in postmenopausal Asian women: fracture burden and incremental risk stratification beyond hip BMD.Archives of osteoporosis · 2026Article
- Correlation Between the Deltoid Tuberosity Index and DXA Measurements: Feasibility of Opportunistic Osteoporosis Screening Using Routine Radiograph.Calcified tissue international · 2026Article
- Updates on the Role of DXA in the Evaluation and Monitoring of Osteoporosis.Current rheumatology reports · 2025Review
- Effect of FRAXplus adjustments on fracture risk reclassification in older Swedish women-results from the SUPERB-study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Delineating the relationship between circulating osteoprotegerin and bone health in women with a pathogenic variant inBone reports · 2024Article
- An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis.Journal of endocrinological investigation · 2024Review
- Unravelling hip-spine bone mineral density discordance in people living with HIV.Journal of bone and mineral metabolism · 2022Article
- Comparative Analysis of T-Score Discordance between a Registry-Based Korean Population and Atypical Femoral Fracture Patients of a Single Institution.Clinics in orthopedic surgery · 2022Article
- Prevalence, Clinical Implication, and Cause of Spine Hip Discordance in Elderly Patients with Fragility Hip Fracture.Journal of bone metabolism · 2022Article
- Discordance in Bone Mineral Density between the Lumbar Spine and Femoral Neck Is Associated with Renal Dysfunction.Yonsei medical journal · 2022Article
- Discordance between Hip and Spine Bone Mineral Density: A Point of Care.Journal of bone metabolism · 2021Article
- Pharmacogenomic Effects of β-Blocker Use on Femoral Neck Bone Mineral Density.Journal of the Endocrine Society · 2021Article
- Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms.SAGE open medicine · 2021Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
There are occasional marked discordances in BMD T-scores at the lumbar spine (LS) and femoral neck (FN). We investigated whether such discordances could contribute independently to fracture prediction using FRAX. We studied 21,158 women, average age 63 years, from 10 prospective cohorts with baseline FRAX variables as well as FN and LS BMD. Incident fractures were collected by self-report and/or radiographic reports. Extended Poisson regression examined the relationship between differences in LS and FN T-scores (ΔLS-FN) and fracture risk, adjusted for age, time since baseline and other factors including FRAX 10-year probability for major osteoporotic fracture calculated using FN BMD. To examine the effect of an adjustment for ΔLS-FN on reclassification, women were separated into risk categories by their FRAX major fracture probability. High risk was classified using two approaches: being above the National Osteoporosis Guideline Group intervention threshold or, separately, being in the highest third of each cohort. The absolute ΔLS-FN was greater than 2 SD for 2.5% of women and between 1 and 2 SD for 21%. ΔLS-FN was associated with a significant risk of fracture adjusted for baseline FRAX (HR per SD change = 1.09; 95% CI = 1.04-1.15). In reclassification analyses, only 2.3-3.2% of the women moved to a higher or lower risk category when using FRAX with ΔLS-FN compared with FN-derived FRAX alone. Adjustment of estimated fracture risk for a large LS/FN discrepancy (>2SD) impacts to a large extent on only a relatively small number of individuals. More moderate (1-2SD) discordances in FN and LS T-scores have a small impact on FRAX probabilities. This might still improve clinical decision-making, particularly in women with probabilities close to an intervention threshold.
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Registered trials
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