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Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.

Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.
Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.
Summary
The IOF Epidemiology and Quality of Life Working Group has reviewed the potential role of population screening for high hip fracture risk against well-established criteria. The report concludes that such an approach should strongly be considered in many health care systems to reduce the burden of hip fractures.

Introduction
The burden of long-term osteoporosis management falls on primary care in most healthcare systems. However, a wide and stable treatment gap exists in many such settings; most of which appears to be secondary to a lack of awareness of fracture risk. Screening is a public health measure for the purpose of identifying individuals who are likely to benefit from further investigations and/or treatment to reduce the risk of a disease or its complications. The purpose of this report was to review the evidence for a potential screening programme to identify postmenopausal women at increased risk of hip fracture.

Methods
The approach took well-established criteria for the development of a screening program, adapted by the UK National Screening Committee, and sought the opinion of 20 members of the International Osteoporosis Foundation’s Working Group on Epidemiology and Quality of Life as to whether each criterion was met (yes, partial or no). For each criterion, the evidence base was then reviewed and summarized.

Results and Conclusion
The report concludes that evidence supports the proposal that screening for high fracture risk in primary care should strongly be considered for incorporation into many health care systems to reduce the burden of fractures, particularly hip fractures. The key remaining hurdles to overcome are engagement with primary care healthcare professionals, and the implementation of systems that facilitate and maintain the screening program.
Cost-effectiveness, FRAX, Fracture risk, Screening, Treatment
1862-3522
Chotiyarnwong, Pojchong
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McCloskey, E. V.
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Harvey, Nicholas
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Lorentzon, M.
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Prieto-Alhambra, Daniel
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Abrahamsen, B.
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Adachi, J.D
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Borgström, F.
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Bruyère, Olivier
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Carey, J J
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Clark, P.
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Cooper, Cyrus
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Curtis, Elizabeth
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Dennison, Elaine
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Diaz Curiel, Manuel
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Dimai, H.P.
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Grigorie, D.
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Hiligsmann, Mickaël
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Khashayar, Patricia
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Lewiecki, E. Michael
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Lips, P.
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Lorenc, R.S.
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Ortolani, S.
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Papaioannou, A.
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Silverman, S.
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Sosa-Henríquez, Manuel
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Szulc, Pawel
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Ward, Kate
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Yoshimura, N.
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Kanis, J A.
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Chotiyarnwong, Pojchong
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McCloskey, E. V.
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Harvey, Nicholas
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Lorentzon, M.
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Prieto-Alhambra, Daniel
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Abrahamsen, B.
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Adachi, J.D
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Borgström, F.
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Bruyère, Olivier
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Carey, J J
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Clark, P.
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Cooper, Cyrus
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Curtis, Elizabeth
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Dennison, Elaine
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Diaz Curiel, Manuel
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Dimai, H.P.
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Grigorie, D.
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Hiligsmann, Mickaël
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Khashayar, Patricia
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Lewiecki, E. Michael
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Lips, P.
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Lorenc, R.S.
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Ortolani, S.
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Papaioannou, A.
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Silverman, S.
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Sosa-Henríquez, Manuel
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Szulc, Pawel
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Ward, Kate
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Yoshimura, N.
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Kanis, J A.
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Chotiyarnwong, Pojchong, McCloskey, E. V., Harvey, Nicholas, Lorentzon, M., Prieto-Alhambra, Daniel, Abrahamsen, B., Adachi, J.D, Borgström, F., Bruyère, Olivier, Carey, J J, Clark, P., Cooper, Cyrus, Curtis, Elizabeth, Dennison, Elaine, Diaz Curiel, Manuel, Dimai, H.P., Grigorie, D., Hiligsmann, Mickaël, Khashayar, Patricia, Lewiecki, E. Michael, Lips, P., Lorenc, R.S., Ortolani, S., Papaioannou, A., Silverman, S., Sosa-Henríquez, Manuel, Szulc, Pawel, Ward, Kate, Yoshimura, N. and Kanis, J A. (2022) Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group. Archives of Osteoporosis, 17 (1), [87]. (doi:10.1007/s11657-022-01117-6).

Record type: Article

Abstract

Summary
The IOF Epidemiology and Quality of Life Working Group has reviewed the potential role of population screening for high hip fracture risk against well-established criteria. The report concludes that such an approach should strongly be considered in many health care systems to reduce the burden of hip fractures.

Introduction
The burden of long-term osteoporosis management falls on primary care in most healthcare systems. However, a wide and stable treatment gap exists in many such settings; most of which appears to be secondary to a lack of awareness of fracture risk. Screening is a public health measure for the purpose of identifying individuals who are likely to benefit from further investigations and/or treatment to reduce the risk of a disease or its complications. The purpose of this report was to review the evidence for a potential screening programme to identify postmenopausal women at increased risk of hip fracture.

Methods
The approach took well-established criteria for the development of a screening program, adapted by the UK National Screening Committee, and sought the opinion of 20 members of the International Osteoporosis Foundation’s Working Group on Epidemiology and Quality of Life as to whether each criterion was met (yes, partial or no). For each criterion, the evidence base was then reviewed and summarized.

Results and Conclusion
The report concludes that evidence supports the proposal that screening for high fracture risk in primary care should strongly be considered for incorporation into many health care systems to reduce the burden of fractures, particularly hip fractures. The key remaining hurdles to overcome are engagement with primary care healthcare professionals, and the implementation of systems that facilitate and maintain the screening program.

Text
s11657-022-01117-6 - Version of Record
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Accepted/In Press date: 3 May 2022
e-pub ahead of print date: 28 June 2022
Published date: 28 June 2022
Additional Information: Funding Information: E.V.M reports consultant/advisor fees, speaker honoraria and or, research funding from AgNovos, Amgen, Consilient Healthcare, Fresenius Kabi, Gedeon Richter, Internis, Lilly, Novartis, ObsEva, Synexus and UCB, all outside the submitted work. E.M.C. reports lecture fees and travel support from Eli Lilly, Pfizer and UCB, outside the submitted work. N.C.H. reports personal fees, consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, UCB, Kyowa Kirin, Servier, Shire, Consilient Healthcare and Internis Pharma, outside the submitted work. J.A.K. reports a grant from UCB, outside the submitted work. He is the architect of FRAX® but has no financial interest. C.C. reports personal fees from ABBH, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier and Takeda, outside the submitted work. B.A. reports grants and personal fees from UCB, personal fees from Amgen, grants from Novartis, grants and personal fees from Pharma-cosmos, grants and personal fees from Kyowa Kirin, personal fees for Gedeon Richter outside the submitted work. BA also serves on the NovoNordisk Foundation Grants Committee on Endocrinology and Metabolism. M.L. reports lecture fees from Amgen, Astellas, Lilly, Meda, Renapharma and UCB Pharma and consulting fees from Amgen, Radius Health, UCB Pharma, Renapharma and Consilient Health, outside the submitted work. D.P-A. reports institutional receipt of speaker fees from AMGEN and UCB Biopharma; consultancy fees from UCB Biopharma; research grants from UCB, Amgen, and Les Laboratoires Servier, all outside of the submitted work. J. A. reports grants and personal fees from Amgen outside the submitted work, grants from Radius and has been an advisor to Gilead and is part of their speaker’s bureau, outside the submitted work. F.B. is employed and is a shareholder in Quantify Research, a health economic research consultancy, outside of the submitted work. O.B. reports grant support from IBSA, MSD, Nutraveris, Novartis, Pfizer, Rottapharm, Servier and Theramex; consulting or lecture fees from Bayer, Genevrier, IBSA, Rottapharm, Servier, SMB and TRB Chemedica; all outside the submitted work. All other authors have no relevant conflicts of interest in relation to the submitted work. Funding Information: This position paper was prepared by the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group and has been endorsed by the International Osteoporosis Foundation. We are grateful for administrative support from Dr Dominique Pierroz. Funding Information: Work informing this project was supported by the UK Medical Research Foundation (MRF-145–0011-DG-HARV-C0913). N.C.H., E.M.C., E.M.D. and C.C. are supported by the UK Medical Research Council (MC_PC_21003; MC_PC_21001). Publisher Copyright: © 2022, The Author(s).
Keywords: Cost-effectiveness, FRAX, Fracture risk, Screening, Treatment

Identifiers

Local EPrints ID: 468276
URI: http://eprints.soton.ac.uk/id/eprint/468276
ISSN: 1862-3522
PURE UUID: 15304355-8b26-489a-91a4-954da0f2e250
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750

Catalogue record

Date deposited: 09 Aug 2022 16:40
Last modified: 18 Mar 2024 03:38

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Contributors

Author: Pojchong Chotiyarnwong
Author: E. V. McCloskey
Author: Nicholas Harvey ORCID iD
Author: M. Lorentzon
Author: Daniel Prieto-Alhambra
Author: B. Abrahamsen
Author: J.D Adachi
Author: F. Borgström
Author: Olivier Bruyère
Author: J J Carey
Author: P. Clark
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD
Author: Manuel Diaz Curiel
Author: H.P. Dimai
Author: D. Grigorie
Author: Mickaël Hiligsmann
Author: Patricia Khashayar
Author: E. Michael Lewiecki
Author: P. Lips
Author: R.S. Lorenc
Author: S. Ortolani
Author: A. Papaioannou
Author: S. Silverman
Author: Manuel Sosa-Henríquez
Author: Pawel Szulc
Author: Kate Ward ORCID iD
Author: N. Yoshimura
Author: J A. Kanis

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