Evidence map›Paper›PMID 32306163›Full record

ArticleArchives of osteoporosis2020

Fragility fractures in Europe: burden, management and opportunities.

Fredrik Borgström, Linda Karlsson, Gustav Ortsäter, Nicolas Norton, Philippe Halbout, Cyrus Cooper, Mattias Lorentzon, Eugene V McCloskey, Nicholas C Harvey, Muhamamd K Javaid and 2 more

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of osteoporosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 456 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
456citing papers in PubMed, 13 pooled it
–field-weighted citation impact
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

456 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  4. 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
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  10. Effects of combined protein and exercise interventions on bone health in middle-aged and older adults - A systematic literature review and meta-analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
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  13. Osteoprotective effect ofPharmaceutical biology · 2024
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  18. Efficacy and safety of candidate biosimilar CT-P41 versus reference denosumab: a double-blind, randomized, active-controlled, Phase 3 trial in postmenopausal women with osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
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  20. Review

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

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Fredrik BorgströmMedical Management Centre, Department of Learning Informatics, Management and Ethics, Karolinska Institute, Solna, Sweden.
Linda KarlssonQuantify Research, Stockholm, Sweden.
Gustav OrtsäterQuantify Research, Stockholm, Sweden.
Nicolas NortonQuantify Research, Stockholm, Sweden.
Philippe HalboutInternational Osteoporosis Foundation, Nyon, Switzerland.
Cyrus CooperMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Mattias LorentzonMary MacKillop Health Institute, Catholic University of Australia, Melbourne, Australia.
Eugene V McCloskeyCentre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Muhamamd K JavaidNational Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
John A KanisMary MacKillop Health Institute, Catholic University of Australia, Melbourne, Australia. w.j.Pontefract@shef.ac.uk.
International Osteoporosis Foundation

Funding

Department of Health 10/33/04Medical Research Council G0400491Medical Research Council MC_U147585819Medical Research Council MC_U147585824Medical Research Council MC_U147585827Medical Research Council MC_UP_A620_1014Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/1Medical Research Council MC_UU_12011/2
6 · The paper itself

Abstract

This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five countries of the European Union plus Sweden (EU6). In 2017, new fragility fractures in the EU6 are estimated at 2.7 million with an associated annual cost of €37.5 billion and a loss of 1.0 million quality-adjusted life years.

introductionOsteoporosis is characterized by reduced bone mass and strength, which increases the risk of fragility fractures, which in turn, represent the main consequence of the disease. This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five EU countries and Sweden (designated the EU6).

methodsA series of metrics describing the burden and management of fragility fractures were defined by a scientific steering committee. A working group performed the data collection and analysis. Data were collected from current literature, available retrospective data and public sources. Different methods were applied (e.g. standard statistics and health economic modelling), where appropriate, to perform the analysis for each metric.

resultsTotal fragility fractures in the EU6 are estimated to increase from 2.7 million in 2017 to 3.3 million in 2030; a 23% increase. The resulting annual fracture-related costs (€37.5 billion in 2017) are expected to increase by 27%. An estimated 1.0 million quality-adjusted life years (QALYs) were lost in 2017 due to fragility fractures. The current disability-adjusted life years (DALYs) per 1000 individuals age 50 years or more were estimated at 21 years, which is higher than the estimates for stroke or chronic obstructive pulmonary disease. The treatment gap (percentage of eligible individuals not receiving treatment with osteoporosis drugs) in the EU6 is estimated to be 73% for women and 63% for men; an increase of 17% since 2010. If all patients who fracture in the EU6 were enrolled into fracture liaison services, at least 19,000 fractures every year might be avoided.

conclusionsFracture-related burden is expected to increase over the coming decades. Given the substantial treatment gap and proven cost-effectiveness of fracture prevention schemes such as fracture liaison services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are appropriately assessed and treated.

Indexed as

Cost of IllnessAgedEuropeFemaleHealthcare DisparitiesHumansMaleMiddle AgedOsteoporosisOsteoporotic FracturesQuality-Adjusted Life YearsRetrospective StudiesSwedenDisability-adjusted life yearsFracture costsFragility fractureQuality-adjusted life yearsTreatment gap

Identifiers

PMID32306163
PMCPMC7166207

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.