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The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women

Kanis, J. A.; Oden, A.; Johnell, Olof LU ; Johansson, H.; De Laet, C.; Brown, J.; Burckhardt, P.; Cooper, C.; Christiansen, C. and Cummings, S., et al. (2007) In Osteoporosis International 18(8). p.1033-1046
Abstract
BMD and clinical risk factors predict hip and other osteoporotic fractures. The combination of clinical risk factors and BMD provide higher specificity and sensitivity than either alone. Introduction and hypotheses To develop a risk assessment tool based on clinical risk factors (CRFs) with and without BMD. Methods Nine population-based studies were studied in which BMD and CRFs were documented at baseline. Poisson regression models were developed for hip fracture and other osteoporotic fractures, with and without hip BMD. Fracture risk was expressed as gradient of risk (GR, risk ratio/SD change in risk score). Results CRFs alone predicted hip fracture with a GR of 2.1/SD at the age of 50 years and decreased with age. The use of BMD alone... (More)
BMD and clinical risk factors predict hip and other osteoporotic fractures. The combination of clinical risk factors and BMD provide higher specificity and sensitivity than either alone. Introduction and hypotheses To develop a risk assessment tool based on clinical risk factors (CRFs) with and without BMD. Methods Nine population-based studies were studied in which BMD and CRFs were documented at baseline. Poisson regression models were developed for hip fracture and other osteoporotic fractures, with and without hip BMD. Fracture risk was expressed as gradient of risk (GR, risk ratio/SD change in risk score). Results CRFs alone predicted hip fracture with a GR of 2.1/SD at the age of 50 years and decreased with age. The use of BMD alone provided a higher GR (3.7/SD), and was improved further with the combined use of CRFs and BMD (4.2/SD). For other osteoporotic fractures, the GRs were lower than for hip fracture. The GR with CRFs alone was 1.4/SD at the age of 50 years, similar to that provided by BMD (GR=1.4/SD) and was not markedly increased by the combination (GR=1.4/SD). The performance characteristics of clinical risk factors with and without BMD were validated in eleven independent population-based cohorts. Conclusions The models developed provide the basis for the integrated use of validated clinical risk factors in men and women to aid in fracture risk prediction. (Less)
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publication status
published
subject
keywords
fracture, osteoporotic, meta-analysis, bone mineral density, hip fracture, risk assessment
in
Osteoporosis International
volume
18
issue
8
pages
1033 - 1046
publisher
Springer
external identifiers
  • wos:000247786600003
  • scopus:34347372696
ISSN
1433-2965
DOI
10.1007/s00198-007-0343-y
language
English
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yes
id
b819da38-8ada-497f-a0f7-a70116a74105 (old id 648698)
date added to LUP
2007-12-13 09:59:26
date last changed
2017-11-05 04:32:34
@article{b819da38-8ada-497f-a0f7-a70116a74105,
  abstract     = {BMD and clinical risk factors predict hip and other osteoporotic fractures. The combination of clinical risk factors and BMD provide higher specificity and sensitivity than either alone. Introduction and hypotheses To develop a risk assessment tool based on clinical risk factors (CRFs) with and without BMD. Methods Nine population-based studies were studied in which BMD and CRFs were documented at baseline. Poisson regression models were developed for hip fracture and other osteoporotic fractures, with and without hip BMD. Fracture risk was expressed as gradient of risk (GR, risk ratio/SD change in risk score). Results CRFs alone predicted hip fracture with a GR of 2.1/SD at the age of 50 years and decreased with age. The use of BMD alone provided a higher GR (3.7/SD), and was improved further with the combined use of CRFs and BMD (4.2/SD). For other osteoporotic fractures, the GRs were lower than for hip fracture. The GR with CRFs alone was 1.4/SD at the age of 50 years, similar to that provided by BMD (GR=1.4/SD) and was not markedly increased by the combination (GR=1.4/SD). The performance characteristics of clinical risk factors with and without BMD were validated in eleven independent population-based cohorts. Conclusions The models developed provide the basis for the integrated use of validated clinical risk factors in men and women to aid in fracture risk prediction.},
  author       = {Kanis, J. A. and Oden, A. and Johnell, Olof and Johansson, H. and De Laet, C. and Brown, J. and Burckhardt, P. and Cooper, C. and Christiansen, C. and Cummings, S. and Eisman, J. A. and Fujiwara, S. and Glueer, C. and Goltzman, D. and Hans, D. and Krieg, M.-A. and La Croix, A. and McCloskey, E. and Mellstrom, D. and Melton, L. J., III and Pols, H. and Reeve, J. and Sanders, K. and Schott, A.-M. and Silman, A. and Torgerson, D. and van Staa, T. and Watts, N. B. and Yoshimura, N.},
  issn         = {1433-2965},
  keyword      = {fracture,osteoporotic,meta-analysis,bone mineral density,hip fracture,risk assessment},
  language     = {eng},
  number       = {8},
  pages        = {1033--1046},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women},
  url          = {http://dx.doi.org/10.1007/s00198-007-0343-y},
  volume       = {18},
  year         = {2007},
}