ArticleBiomechanics and modeling in mechanobiology2019
A multiscale model to predict current absolute risk of femoral fracture in a postmenopausal population.
Article in Biomechanics and modeling in mechanobiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- CT image-based biomarkers for opportunistic screening of osteoporotic fractures: 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 · 2024Pooled it
- Segmentation methods for quantifying X-ray Computed Tomography based biomarkers to assess hip fracture risk: a systematic literature review.Frontiers in bioengineering and biotechnology · 2024Pooled it
- Sex-specific predictive equations for estimating trochanteric soft tissue thickness across body positions and imaging modalities.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Improved prediction of hip fracture using multi-faceted biomechanical computed tomography.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Can Multi-Vertebral CT-Based Finite Element Models Accurately Predict Strains? An In Vitro Validation Study.International journal for numerical methods in biomedical engineering · 2025Article
- Comparison of the time-dependent discriminatory accuracy of femoral strength and bone mineral density for predicting future hip and major osteoporotic fractures: a 16-year follow-up of the AGES-Reykjavik cohort.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- In Silico Clinical Trial for Osteoporosis Treatments to Prevent Hip Fractures: Simulation of the Placebo Arm.Annals of biomedical engineering · 2025Article
- Development and validation of a semi-automated and unsupervised method for femur segmentation from CT.Scientific reports · 2024Article
- Phantomless calibration of CT scans for hip fracture risk prediction in silico: Comparison with phantom-based calibration.PloS one · 2024Article
- Automatic segmentation of lower limb muscles from MR images of post-menopausal women based on deep learning and data augmentation.PloS one · 2024Article
- Osteoporosis: Molecular Pathology, Diagnostics, and Therapeutics.International journal of molecular sciences · 2023Review
- Statistical Properties of a Virtual Cohort for In Silico Trials Generated with a Statistical Anatomy Atlas.Annals of biomedical engineering · 2023Article
- 2D-3D reconstruction of the proximal femur from DXA scans: Evaluation of the 3D-Shaper software.Frontiers in bioengineering and biotechnology · 2023Article
- A Review of CT-Based Fracture Risk Assessment with Finite Element Modeling and Machine Learning.Current osteoporosis reports · 2022Review
- Personalised 3D Assessment of Trochanteric Soft Tissues Improves HIP Fracture Classification Accuracy.Annals of biomedical engineering · 2022Article
- Improving the Hip Fracture Risk Prediction with a Statistical Shape-and-Intensity Model of the Proximal Femur.Annals of biomedical engineering · 2022Article
- Finite Element Assessment of Bone Fragility from Clinical Images.Current osteoporosis reports · 2021Review
- Body Anthropometry and Bone Strength Conjointly Determine the Risk of Hip Fracture in a Sideways Fall.Annals of biomedical engineering · 2021Article
- Biomechanical Computed Tomography analysis (BCT) for clinical assessment of osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Review
- Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis-A Survey.Materials (Basel, Switzerland) · 2019Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
Osteoporotic hip fractures are a major healthcare problem. Fall severity and bone strength are important risk factors of hip fracture. This study aims to obtain a mechanistic explanation for fracture risk in dependence of these risk factors. A novel modelling approach is developed that combines models at different scales to overcome the challenge of a large space-time domain of interest and considers the variability of impact forces between potential falls in a subject. The multiscale model and its component models are verified with respect to numerical approximations made therein, the propagation of measurement uncertainties of model inputs is quantified, and model predictions are validated against experimental and clinical data. The main results are model predicted absolute risk of current fracture (ARF0) that ranged from 1.93 to 81.6% (median 36.1%) for subjects in a retrospective cohort of 98 postmenopausal British women (49 fracture cases and 49 controls); ARF0 was computed up to a precision of 1.92 percentage points (pp) due to numerical approximations made in the model; ARF0 possessed an uncertainty of 4.00 pp due to uncertainties in measuring model inputs; ARF0 classified observed fracture status in the above cohort with AUC = 0.852 (95% CI 0.753-0.918), 77.6% specificity (95% CI 63.4-86.5%) and 81.6% sensitivity (95% CI 68.3-91.1%). These results demonstrate that ARF0 can be computed using the model with sufficient precision to distinguish between subjects and that the novel mechanism of fracture risk determination based on fall dynamics, hip impact and bone strength can be considered validated.
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Registered trials
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.