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Validity of parental recall of children’s fracture: implications for investigation of childhood osteoporosis

Validity of parental recall of children’s fracture: implications for investigation of childhood osteoporosis
Validity of parental recall of children’s fracture: implications for investigation of childhood osteoporosis

Summary

Fracture history is an important component of osteoporosis diagnosis in children. One in six parentally reported lifetime fractures in children were not confirmed on review of radiographs. Care should be taken to avoid unnecessary investigations for possible osteoporosis due to parental over-reporting of soft tissue injuries as fractures.


Introduction

The diagnosis of osteoporosis in children requires either a vertebral compression fracture, or a significant fracture history (defined as ?2 long bone fractures <10 years or ?3 long bone fractures <19 years, excluding high impact fractures) and low bone mineral density. As children with frequent fractures might benefit from further evaluation, we determined whether parental reports of lifetime fracture were accurate compared to radiological reports and if they appropriately selected children for further consideration of osteoporosis.


Methods

Parents of children (<18 years) with a musculoskeletal injury completed a questionnaire on their child’s fracture history, including age, site and mechanism of previous fracture(s). Radiological reports were reviewed to confirm the fracture.


Results

Six hundred sixty parents completed the questionnaire and reported 276 previous fractures in 207 children. An injury treated at our hospital was recorded in 214 of the 276 parentally reported fractures. Thirty-four of 214 (16 %) were not a confirmed fracture. An injury was recorded for all parentally reported fractures in 150 children, but for 21 % children, there were inaccurate details (no evidence of fracture, incorrect site or forgotten fractures) on parent report. Eighteen of 150 children had a significant fracture history on parental report alone, but following review of radiology reports, 2 of 18 (11 %) did not have clinically significant fracture histories.


Conclusions

Approximately one in six fractures reported by parents to have occurred in their child’s lifetime had not resulted in a fracture. One in nine children with a significant fracture history could have been investigated unnecessarily.
fracture, mental recall, osteoporosis, paediatric, parent
0937-941X
809-813
Moon, R. J.
954fb3ed-9934-4649-886d-f65944985a6b
Lim, A.
5d5b1699-7084-48e8-b7df-48242c8edcda
Farmer, M.
df3108d7-d9c4-40e3-82b2-03c64842ce04
Segaran, A.
415039ea-b60d-4830-94bf-e13805d7a586
Clarke, N. M. P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Harvey, N. C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Davies, J. H.
9f18fcad-f488-4c72-ac23-c154995443a9
Moon, R. J.
954fb3ed-9934-4649-886d-f65944985a6b
Lim, A.
5d5b1699-7084-48e8-b7df-48242c8edcda
Farmer, M.
df3108d7-d9c4-40e3-82b2-03c64842ce04
Segaran, A.
415039ea-b60d-4830-94bf-e13805d7a586
Clarke, N. M. P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Harvey, N. C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Davies, J. H.
9f18fcad-f488-4c72-ac23-c154995443a9

Moon, R. J., Lim, A., Farmer, M., Segaran, A., Clarke, N. M. P., Harvey, N. C., Cooper, C. and Davies, J. H. (2016) Validity of parental recall of children’s fracture: implications for investigation of childhood osteoporosis. Osteoporosis International, 27 (2), 809-813. (doi:10.1007/s00198-015-3287-7). (PMID:26286627)

Record type: Article

Abstract


Summary

Fracture history is an important component of osteoporosis diagnosis in children. One in six parentally reported lifetime fractures in children were not confirmed on review of radiographs. Care should be taken to avoid unnecessary investigations for possible osteoporosis due to parental over-reporting of soft tissue injuries as fractures.


Introduction

The diagnosis of osteoporosis in children requires either a vertebral compression fracture, or a significant fracture history (defined as ?2 long bone fractures <10 years or ?3 long bone fractures <19 years, excluding high impact fractures) and low bone mineral density. As children with frequent fractures might benefit from further evaluation, we determined whether parental reports of lifetime fracture were accurate compared to radiological reports and if they appropriately selected children for further consideration of osteoporosis.


Methods

Parents of children (<18 years) with a musculoskeletal injury completed a questionnaire on their child’s fracture history, including age, site and mechanism of previous fracture(s). Radiological reports were reviewed to confirm the fracture.


Results

Six hundred sixty parents completed the questionnaire and reported 276 previous fractures in 207 children. An injury treated at our hospital was recorded in 214 of the 276 parentally reported fractures. Thirty-four of 214 (16 %) were not a confirmed fracture. An injury was recorded for all parentally reported fractures in 150 children, but for 21 % children, there were inaccurate details (no evidence of fracture, incorrect site or forgotten fractures) on parent report. Eighteen of 150 children had a significant fracture history on parental report alone, but following review of radiology reports, 2 of 18 (11 %) did not have clinically significant fracture histories.


Conclusions

Approximately one in six fractures reported by parents to have occurred in their child’s lifetime had not resulted in a fracture. One in nine children with a significant fracture history could have been investigated unnecessarily.

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More information

Accepted/In Press date: 11 August 2015
e-pub ahead of print date: 19 August 2015
Published date: February 2016
Keywords: fracture, mental recall, osteoporosis, paediatric, parent
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 380772
URI: http://eprints.soton.ac.uk/id/eprint/380772
ISSN: 0937-941X
PURE UUID: e0601da8-d272-48e5-82ca-555e037e9374
ORCID for N. C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 17 Sep 2015 13:21
Last modified: 10 Dec 2019 01:53

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