Evidence map›Paper›PMID 26968752›Full record

ArticleBone2016

Epidemiology of fractures in the United Kingdom 1988-2012: Variation with age, sex, geography, ethnicity and socioeconomic status.

Elizabeth M Curtis, Robert van der Velde, Rebecca J Moon, Joop P W van den Bergh, Piet Geusens, Frank de Vries, Tjeerd P van Staa, Cyrus Cooper, Nicholas C Harvey

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bone, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 240 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
240citing papers in PubMed, 22 pooled it
27.6field-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

240 citing papers in PubMed, 22 syntheses or guidelines pooled it, 464 citations in OpenAlex.

  1. Pooled it
  2. What is the association between physical activity and fracture risk in middle-aged adults (aged 30-60): a systematic review and synthesis without meta-analysis (SWIM).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. Guideline
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  6. Impact of deep learning on pediatric elbow fracture detection: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Pooled it
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  8. Does adding exercise or physical activity to pharmacological osteoporosis therapy in patients with increased fracture risk improve bone mineral density and lower fracture risk? A systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Pooled it
  9. A systematic review of cost‑effectiveness analyses of sequential treatment for osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Pooled it
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  13. Cost-effectiveness analyses of denosumab for osteoporosis: a systematic review.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
  14. Guideline
  15. Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis.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
  16. Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Pooled it
  17. Systematic review of major osteoporotic fracture to hip fracture incidence rate ratios worldwide: implications for Fracture Risk Assessment Tool (FRAX)-derived estimates.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2021
    Pooled it
  18. Effectiveness of parathyroid hormone (PTH) analogues on fracture healing: a meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Pooled it
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  20. Pooled it

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Elizabeth M CurtisMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK.
Robert van der VeldeDept of Internal Medicine, VieCuri Medical Center, Venloseweg, 595971 PB Venlo, The Netherlands.
Rebecca J MoonMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK; Paediatric Endocrinology, Southampton University Hospitals NHS Foundation Trust, Southampton SO16 6YD, UK.
Joop P W van den BerghDept of Internal Medicine, VieCuri Medical Center, Venloseweg, 595971 PB Venlo, The Netherlands; Maastricht University Medical Center, Maastricht, The Netherlands.
Piet GeusensDepartment of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands; University Hasselt, Hasselt, Belgium.
Frank de VriesDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Pharmacoepidemiology & Clinical Pharmacology, University of Utrecht, Utrecht 3508 TB, The Netherlands.
Tjeerd P van StaaDepartment of Pharmacoepidemiology & Clinical Pharmacology, University of Utrecht, Utrecht 3508 TB, The Netherlands; Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester, 1.003 Vaughan House, Portsmouth Road, M13 9PL, UK.
Cyrus CooperMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopedic Centre, Headington, Oxford OX3 7HE, UK. Electronic address: cc@mrc.soton.ac.uk.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
University Hospital Southampton NHS Foundation Trust · GBUtrecht University · NLMaastricht University · NLMaastricht University Medical Centre · NLMRC Lifecourse Epidemiology Unit · GBVieCuri Medisch Centrum · NL

Funding

Arthritis Research UK 17702Arthritis Research UK 21231Department of Health 10/33/04Department of Health HTA/10/33/04Medical Research Council G0400491Medical Research Council MC_PC_13042Medical Research Council MC_U147585819Medical Research Council MC_U147585824Medical Research Council MC_U147585827Medical Research Council MC_UP_A620_1014Medical Research Council MC_UU_12011/1Medical Research Council MR/K006665/1Wellcome Trust 201222/Z/16/Z
6 · The paper itself

Abstract

unlabelledRates of fracture worldwide are changing. Using the Clinical Practice Research Datalink (CPRD), age, and gender, geographical, ethnic and socioeconomic trends in fracture rates across the United Kingdom were studied over a 24-year period 1988-2012. Previously observed patterns in fracture incidence by age and fracture site were evident. New data on the influence of geographic location, ethnic group and socioeconomic status were obtained.

introductionWith secular changes in age- and sex-specific fracture incidence observed in many populations, and global shifts towards an elderly demography, it is vital for health care planners to have an accurate understanding of fracture incidence nationally. We aimed to present up to date fracture incidence data in the UK, stratified by age, sex, geographic location, ethnicity and socioeconomic status.

methodsThe Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records for approximately 6.9% of the UK population. Information comes from General Practitioners, and covers 11.3 million people from 674 practices across the UK, demonstrated to be representative of the national population. The study population consisted of all permanently registered individuals aged ≥18years. Validated data on fracture incidence were obtained from their medical records, as was information on socioeconomic deprivation, ethnicity and geographic location. Age- and sex-specific fracture incidence rates were calculated.

resultsFracture incidence rates by age and sex were comparable to those documented in previous studies and demonstrated a bimodal distribution. Substantial geographic heterogeneity in age- and sex adjusted fracture incidence was observed, with rates in Scotland almost 50% greater than those in London and South East England. Lowest rates of fracture were observed in black individuals of both sexes; rates of fragility fracture in white women were 4.7 times greater than in black women. Strong associations between deprivation and fracture risk were observed in hip fracture in men, with a relative risk of 1.3 (95% CI 1.21-1.41) in Index of Multiple Deprivation category 5 (representing the most deprived) compared to category 1.

conclusionsThis study presents robust estimates of fracture incidence across the UK, which will aid decisions regarding allocation of healthcare provision to populations of greatest need. It will also assist the implementation and design of strategies to reduce fracture incidence and its personal and financial impact on individuals and health services.

Indexed as

Sex CharacteristicsSocial ClassAdolescentAdultAge FactorsEthnicityFemaleFractures, BoneHumansIncidenceMaleMiddle AgedUnited KingdomYoung AdultEpidemiologyEthnicityFracturesGeographyIncidenceOsteoporosisSexSocioeconomic status

Identifiers

PMID26968752
PMCPMC4890652
OpenAlexW2296390309

What OpenQuestion holds

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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.