Empirically Based Composite Fracture Prediction Model From the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW)
Identifieur interne : 004186 ( Main/Exploration ); précédent : 004185; suivant : 004187Empirically Based Composite Fracture Prediction Model From the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW)
Auteurs : Gordon Fitzgerald [États-Unis] ; Juliet E. Compston [Royaume-Uni] ; Roland D. Chapurlat [France] ; Johannes Pfeilschifter [Allemagne] ; Cyrus Cooper [Royaume-Uni] ; David W. Jr Hosmer [États-Unis] ; Jonathan D. Adachi [Canada] ; Frederick A. Jr Anderson [États-Unis] ; Adolfo Diez-Perez [Espagne] ; Susan L. Greenspan [États-Unis] ; J. Coen Netelenbos [Pays-Bas] ; Jeri W. Nieves [États-Unis] ; Maurizio Rossini [Italie] ; Nelson B. Watts [États-Unis] ; Frederick H. Hooven [États-Unis] ; Andrea Z. Lacroix [États-Unis] ; Lyn March [Australie] ; Christian Roux [France] ; Kenneth G. Saag [États-Unis] ; Ethel S. Siris [États-Unis] ; Stuart Silverman ; Stephen H. Gehlbach [États-Unis]Source :
- The Journal of clinical endocrinology and metabolism [ 0021-972X ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Facteurs de l'âge, Facteurs de risque, Femelle, Fractures osseuses (diagnostic), Fractures osseuses (épidémiologie), Fractures osseuses (étiologie), Humains, Modèles statistiques, Ostéoporose post-ménopausique (), Ostéoporose post-ménopausique (diagnostic), Ostéoporose post-ménopausique (épidémiologie), Pronostic, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études longitudinales.
- MESH :
- diagnostic : Fractures osseuses, Ostéoporose post-ménopausique.
- épidémiologie : Fractures osseuses, Ostéoporose post-ménopausique.
- étiologie : Fractures osseuses.
- Pascal (Inist)
- Adulte d'âge moyen, Facteurs de l'âge, Facteurs de risque, Femelle, Fracture, Humains, Modèles statistiques, Ostéoporose post-ménopausique, Pronostic, Prédiction, Facteur prédictif, Ostéoporose, Modèle, Etude longitudinale, Postménopause, Femelle, Femme, Endocrinologie, Maladie métabolique, Nutrition, Obésité, Etat nutritionnel, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études longitudinales.
- Wicri :
English descriptors
- KwdEn :
- Age Factors, Aged, Aged, 80 and over, Cohort Studies, Endocrinology, Female, Follow up study, Fracture, Fractures, Bone (diagnosis), Fractures, Bone (epidemiology), Fractures, Bone (etiology), Humans, Longitudinal Studies, Metabolic diseases, Middle Aged, Models, Models, Statistical, Nutrition, Nutritional status, Obesity, Osteoporosis, Osteoporosis, Postmenopausal (complications), Osteoporosis, Postmenopausal (diagnosis), Osteoporosis, Postmenopausal (epidemiology), Postmenopause, Prediction, Predictive factor, Prognosis, Risk Factors, Woman.
- MESH :
- complications : Osteoporosis, Postmenopausal.
- diagnosis : Fractures, Bone, Osteoporosis, Postmenopausal.
- epidemiology : Fractures, Bone, Osteoporosis, Postmenopausal.
- etiology : Fractures, Bone.
- Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Longitudinal Studies, Middle Aged, Models, Statistical, Prognosis, Risk Factors.
Abstract
Context: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. Objective: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. Design: This was a prospective, observational cohort study. Setting: The study was conducted at primary care practices in 10 countries. Patients: Women aged 55 years or older participated in the study. Intervention: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. Main Outcome Measure: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. Results: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The un-adjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. Conclusions: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model.
Url:
Affiliations:
- Allemagne, Australie, Canada, Espagne, France, Italie, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Auvergne-Rhône-Alpes, Catalogne, Communauté de Madrid, Nouvelle-Galles du Sud, Ontario, Oxfordshire, Pennsylvanie, Rhône-Alpes, État de New York, Île-de-France
- Hamilton (Ontario), Lyon, Oxford, Paris, Pittsburgh, Sydney
- Université McMaster, Université d'Oxford, Université de Pittsburgh
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Le document en format XML
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Compston</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital</s1><s2>Cambridge CB2 0QQ</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Cambridge CB2 0QQ</wicri:noRegion></affiliation></author><author><name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D." last="Chapurlat">Roland D. Chapurlat</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Rheumatology, INSERM Unite Mixte de Recherche 1033, Université de Lyon, and Department of Orthopedics and Rheumatology, Hôpital E. Herriot</s1><s2>69003 Lyon</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>69003 Lyon</wicri:noRegion><placeName><settlement type="city">Lyon</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Internal Medicine III, Alfried Krupp Krankenhaus</s1><s2>Essen 45276</s2><s3>DEU</s3><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>45276</wicri:noRegion><wicri:noRegion>Alfried Krupp Krankenhaus</wicri:noRegion><wicri:noRegion>Essen 45276</wicri:noRegion></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital</s1><s2>Southampton SO16 6YD</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Southampton SO16 6YD</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford</s1><s2>Oxford OX1 3QX</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Hosmer, David W Jr" sort="Hosmer, David W Jr" uniqKey="Hosmer D" first="David W. Jr" last="Hosmer">David W. Jr Hosmer</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Outcomes Research, University of Massachusetts Medical School</s1><s2>Worcester, Massachusetts 01605</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, Massachusetts 01605</wicri:noRegion></affiliation></author><author><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>St Joseph's Hospital, McMaster University</s1><s2>Hamilton, Ontario L8N 1 Y2</s2><s3>CAN</s3><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université McMaster</orgName></affiliation></author><author><name sortKey="Anderson, Frederick A Jr" sort="Anderson, Frederick A Jr" uniqKey="Anderson F" first="Frederick A. Jr" last="Anderson">Frederick A. Jr Anderson</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Outcomes Research, University of Massachusetts Medical School</s1><s2>Worcester, Massachusetts 01605</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, Massachusetts 01605</wicri:noRegion></affiliation></author><author><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Diez-Perez">Adolfo Diez-Perez</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Hospital del Mar-IMIM-Autonomous University of Barcelona</s1><s2>08035 Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><placeName><region nuts="2" type="communauté">Catalogne</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="09"><s1>Research Network on Aging and Frailty, Le Fonds européen de developpement regional (European Regional Development Fund), Instituto de Salud Carlos III</s1><s2>28029 Madrid</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><placeName><region nuts="2" type="communauté">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L." last="Greenspan">Susan L. Greenspan</name><affiliation wicri:level="4"><inist:fA14 i1="10"><s1>University of Pittsburgh</s1><s2>Pittsburgh, Pennsylvania 15213</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J. Coen" last="Netelenbos">J. Coen Netelenbos</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Endocrinology, VU University Medical Centre</s1><s2>Amsterdam 2131 PM Hoofddorp</s2><s3>NLD</s3><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Amsterdam 2131 PM Hoofddorp</wicri:noRegion></affiliation></author><author><name sortKey="Nieves, Jeri W" sort="Nieves, Jeri W" uniqKey="Nieves J" first="Jeri W." last="Nieves">Jeri W. Nieves</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Helen Hayes Hospital and Columbia University, West Haverstraw</s1><s2>New York 10993</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York 10993</wicri:noRegion></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Section of Rheumatology , Department of Medicine, University of Verona</s1><s2>37129 Verona</s2><s3>ITA</s3><sZ>13 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>37129 Verona</wicri:noRegion></affiliation></author><author><name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B." last="Watts">Nelson B. Watts</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Mercy Health</s1><s2>Cincinnati, Ohio 45236</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mercy Health</wicri:noRegion></affiliation></author><author><name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H." last="Hooven">Frederick H. Hooven</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Outcomes Research, University of Massachusetts Medical School</s1><s2>Worcester, Massachusetts 01605</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, Massachusetts 01605</wicri:noRegion></affiliation></author><author><name sortKey="Lacroix, Andrea Z" sort="Lacroix, Andrea Z" uniqKey="Lacroix A" first="Andrea Z." last="Lacroix">Andrea Z. Lacroix</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Fred Hutchinson Cancer Research Center</s1><s2>Seattle, Washington 98109</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Fred Hutchinson Cancer Research Center</wicri:noRegion></affiliation></author><author><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>University of Sydney Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital</s1><s2>2006 Sydney</s2><s3>AUS</s3><sZ>17 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Paris Descartes University and Cochin Hospital</s1><s2>75014 Paris</s2><s3>FRA</s3><sZ>18 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>75014 Paris</wicri:noRegion><placeName><settlement type="city">Paris</settlement><region type="région" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Saag, Kenneth G" sort="Saag, Kenneth G" uniqKey="Saag K" first="Kenneth G." last="Saag">Kenneth G. Saag</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham</s1><s2>Birmingham, Alabama 35294</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Birmingham, Alabama 35294</wicri:noRegion></affiliation></author><author><name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S." last="Siris">Ethel S. Siris</name><affiliation wicri:level="2"><inist:fA14 i1="19"><s1>Columbia University Medical Center, New York</s1><s2>New York 10032</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name></author><author><name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H." last="Gehlbach">Stephen H. Gehlbach</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Outcomes Research, University of Massachusetts Medical School</s1><s2>Worcester, Massachusetts 01605</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, Massachusetts 01605</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">The Journal of clinical endocrinology and metabolism</title><title level="j" type="abbreviated">J. clin. endocrinol. metab.</title><idno type="ISSN">0021-972X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Journal of clinical endocrinology and metabolism</title><title level="j" type="abbreviated">J. clin. endocrinol. metab.</title><idno type="ISSN">0021-972X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Endocrinology</term><term>Female</term><term>Follow up study</term><term>Fracture</term><term>Fractures, Bone (diagnosis)</term><term>Fractures, Bone (epidemiology)</term><term>Fractures, Bone (etiology)</term><term>Humans</term><term>Longitudinal Studies</term><term>Metabolic diseases</term><term>Middle Aged</term><term>Models</term><term>Models, Statistical</term><term>Nutrition</term><term>Nutritional status</term><term>Obesity</term><term>Osteoporosis</term><term>Osteoporosis, Postmenopausal (complications)</term><term>Osteoporosis, Postmenopausal (diagnosis)</term><term>Osteoporosis, Postmenopausal (epidemiology)</term><term>Postmenopause</term><term>Prediction</term><term>Predictive factor</term><term>Prognosis</term><term>Risk Factors</term><term>Woman</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Facteurs de l'âge</term><term>Facteurs de risque</term><term>Femelle</term><term>Fractures osseuses (diagnostic)</term><term>Fractures osseuses (épidémiologie)</term><term>Fractures osseuses (étiologie)</term><term>Humains</term><term>Modèles statistiques</term><term>Ostéoporose post-ménopausique ()</term><term>Ostéoporose post-ménopausique (diagnostic)</term><term>Ostéoporose post-ménopausique (épidémiologie)</term><term>Pronostic</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term><term>Études longitudinales</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Osteoporosis, Postmenopausal</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Fractures, Bone</term><term>Osteoporosis, Postmenopausal</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Fractures osseuses</term><term>Ostéoporose post-ménopausique</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Fractures, Bone</term><term>Osteoporosis, Postmenopausal</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Fractures, Bone</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Fractures osseuses</term><term>Ostéoporose post-ménopausique</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Fractures osseuses</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Longitudinal Studies</term><term>Middle Aged</term><term>Models, Statistical</term><term>Prognosis</term><term>Risk Factors</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Facteurs de l'âge</term><term>Facteurs de risque</term><term>Femelle</term><term>Fracture</term><term>Humains</term><term>Modèles statistiques</term><term>Ostéoporose post-ménopausique</term><term>Pronostic</term><term>Prédiction</term><term>Facteur prédictif</term><term>Ostéoporose</term><term>Modèle</term><term>Etude longitudinale</term><term>Postménopause</term><term>Femelle</term><term>Femme</term><term>Endocrinologie</term><term>Maladie métabolique</term><term>Nutrition</term><term>Obésité</term><term>Etat nutritionnel</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term><term>Études longitudinales</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Femme</term><term>Nutrition</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Context: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. Objective: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. Design: This was a prospective, observational cohort study. Setting: The study was conducted at primary care practices in 10 countries. Patients: Women aged 55 years or older participated in the study. Intervention: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. Main Outcome Measure: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. Results: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The un-adjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. Conclusions: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Canada</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Auvergne-Rhône-Alpes</li><li>Catalogne</li><li>Communauté de Madrid</li><li>Nouvelle-Galles du Sud</li><li>Ontario</li><li>Oxfordshire</li><li>Pennsylvanie</li><li>Rhône-Alpes</li><li>État de New York</li><li>Île-de-France</li></region><settlement><li>Hamilton (Ontario)</li><li>Lyon</li><li>Oxford</li><li>Paris</li><li>Pittsburgh</li><li>Sydney</li></settlement><orgName><li>Université McMaster</li><li>Université d'Oxford</li><li>Université de Pittsburgh</li></orgName></list><tree><noCountry><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Fitzgerald, Gordon" sort="Fitzgerald, Gordon" uniqKey="Fitzgerald G" first="Gordon" last="Fitzgerald">Gordon Fitzgerald</name></noRegion><name sortKey="Anderson, Frederick A Jr" sort="Anderson, Frederick A Jr" uniqKey="Anderson F" first="Frederick A. Jr" last="Anderson">Frederick A. Jr Anderson</name><name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H." last="Gehlbach">Stephen H. Gehlbach</name><name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L." last="Greenspan">Susan L. Greenspan</name><name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H." last="Hooven">Frederick H. Hooven</name><name sortKey="Hosmer, David W Jr" sort="Hosmer, David W Jr" uniqKey="Hosmer D" first="David W. Jr" last="Hosmer">David W. Jr Hosmer</name><name sortKey="Lacroix, Andrea Z" sort="Lacroix, Andrea Z" uniqKey="Lacroix A" first="Andrea Z." last="Lacroix">Andrea Z. Lacroix</name><name sortKey="Nieves, Jeri W" sort="Nieves, Jeri W" uniqKey="Nieves J" first="Jeri W." last="Nieves">Jeri W. Nieves</name><name sortKey="Saag, Kenneth G" sort="Saag, Kenneth G" uniqKey="Saag K" first="Kenneth G." last="Saag">Kenneth G. Saag</name><name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S." last="Siris">Ethel S. Siris</name><name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B." last="Watts">Nelson B. Watts</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name></noRegion><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D." last="Chapurlat">Roland D. Chapurlat</name></region><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name></country><country name="Allemagne"><noRegion><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name></region></country><country name="Espagne"><region name="Catalogne"><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Diez-Perez">Adolfo Diez-Perez</name></region><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Diez-Perez">Adolfo Diez-Perez</name></country><country name="Pays-Bas"><noRegion><name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J. Coen" last="Netelenbos">J. Coen Netelenbos</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name></noRegion></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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