ArticleCancers2022
A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice.
Article in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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.
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Who cites it
6 citing papers in PubMed.
- Diagnostic accuracy of Mirels score, CT-based Structural Rigidity Analysis, and Finite Element Analysis for predicting impending femoral pathologic fractures in metastatic bone disease: a systematic review.Journal of bone oncology · 2026Review
- Femur Fracture Risk Assessment in Patients with Lytic Metastases Using CT-Based Finite Element Models and Bone Crack Simulations Technique.Annals of biomedical engineering · 2026Article
- Photon-Counting CT in Musculoskeletal Radiology: Technical Principles, Clinical Applications, and Future Directions.Journal of the Belgian Society of Radiology · 2026Review
- Femoral strength after cephalomedullary nail removal can be predicted preoperatively using CT based FE models.Scientific reports · 2025Article
- Review
- Internal validation of modified Mirels' scoring system for pathologic femur fractures.BMC musculoskeletal disorders · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Patients with femoral metastases are at risk of fracturing bones. It is important to prevent fractures in order to maintain mobility and quality of life. The BOne Strength (BOS) score is based on a computed tomography (CT)-based patient-specific finite element (FE) computer model that objectively calculates bone strength. In this pilot study, the added clinical value of the BOS score towards treatment-related decision making was assessed. In December 2019, the BOS score was implemented in four radiotherapy centers. The BOS scores and fracture risks of individual patients were calculated and returned to the physician to assist in treatment decisions. The physicians filled out a questionnaire, which was qualitatively analyzed. A follow-up to identify fractures and/or death was performed after six months. Until June 2021, 42 BOS scores were delivered (20 high, 9 moderate, and 13 low fracture risk). In 48%, the BOS score led to an adaptation of treatment plans. Physicians indicated that the BOS score provided objective insight into fracture risk, was reassuring for physicians and patients, and improved multidisciplinary discussions and shared decision making. In conclusion, the BOS score is an objective tool to assess fracture risk in femoral bone metastases and aids physicians and patients in making a more informed decision regarding the most appropriate treatment.
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