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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, O., Johansson, H., De Laet, C., Brown, J., Burckhardt, P., Cooper, C., Christiansen, C., Cummings, S., Eisman, J.A., Fujiwara, S., Gluer, C., Goltzman, D., Hans, D., Krieg, M.A., La Croix, A., McCloskey, E., Mellstrom, D., Melton, L.J., III Pols, H., Reeve, J., Sanders, K., Schott, A.M., Silman, A., Torgerson, D., Van Staa, T., Watts, N.B. and Yoshimura, N. (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women Osteoporosis International, 18, (8), pp. 1033-1046. (doi:10.1007/s00198-007-0343-y).

Record type: Article


SUMMARY: 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.

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Published date: 2007
Keywords: cohort, research, methods, risk, risk factors, disease, risk assessment, fractures, hip, women, bone


Local EPrints ID: 61275
ISSN: 0937-941X
PURE UUID: 3e933cd7-214c-4353-9c7c-7e3018b57eb5
ORCID for C. Cooper: ORCID iD

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Date deposited: 09 Sep 2008
Last modified: 17 Jul 2017 14:22

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Author: J.A. Kanis
Author: A. Oden
Author: O. Johnell
Author: H. Johansson
Author: C. De Laet
Author: J. Brown
Author: P. Burckhardt
Author: C. Cooper ORCID iD
Author: C. Christiansen
Author: S. Cummings
Author: J.A. Eisman
Author: S. Fujiwara
Author: C. Gluer
Author: D. Goltzman
Author: D. Hans
Author: M.A. Krieg
Author: A. La Croix
Author: E. McCloskey
Author: D. Mellstrom
Author: L.J. Melton
Author: H. III Pols
Author: J. Reeve
Author: K. Sanders
Author: A.M. Schott
Author: A. Silman
Author: D. Torgerson
Author: T. Van Staa
Author: N.B. Watts
Author: N. Yoshimura

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