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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Predicting Fractures in an International Cohort using Risk Factor Algorithms, Without Bone Mineral Density</title><author><name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N" last="Sambrook">Philip N. Sambrook</name><affiliation><nlm:aff id="A1">University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Flahive, Julie" sort="Flahive, Julie" uniqKey="Flahive J" first="Julie" last="Flahive">Julie Flahive</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Hooven, Fred H" sort="Hooven, Fred H" uniqKey="Hooven F" first="Fred H" last="Hooven">Fred H. Hooven</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation><nlm:aff id="A3">Leuven University Division of Geriatric Medicine, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Chapurlat, Roland" sort="Chapurlat, Roland" uniqKey="Chapurlat R" first="Roland" last="Chapurlat">Roland Chapurlat</name><affiliation><nlm:aff id="A4">Division of Rheumatology, INSERM U831, Université de Lyon, Hôpital E. Herriot, Lyon, France</nlm:aff></affiliation></author><author><name sortKey="Lindsay, Robert" sort="Lindsay, Robert" uniqKey="Lindsay R" first="Robert" last="Lindsay">Robert Lindsay</name><affiliation><nlm:aff id="A5">Regional Bone Center, Helen Hayes Hospital, West Haverstraw, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Nguyen, Tuan V" sort="Nguyen, Tuan V" uniqKey="Nguyen T" first="Tuan V" last="Nguyen">Tuan V. Nguyen</name><affiliation><nlm:aff id="A6">Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent’s Hospital, Darlinghurst, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Perez">Adolfo Díez-Perez</name><affiliation><nlm:aff id="A7">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation><nlm:aff id="A8">Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</nlm:aff></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><nlm:aff id="A9">University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff></affiliation></author><author><name sortKey="Hosmer, David" sort="Hosmer, David" uniqKey="Hosmer D" first="David" last="Hosmer">David Hosmer</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></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><nlm:aff id="A10">Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</nlm:aff></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><nlm:aff id="A11">St Joseph’s Hospital, McMaster University, Hamilton, ON, Canada</nlm:aff></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><nlm:aff id="A12">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation><nlm:aff id="A13">MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK</nlm:aff></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation><nlm:aff id="A14">Paris Descartes University, Cochin Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation><nlm:aff id="A15">Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</nlm:aff></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><nlm:aff id="A16">Columbia University Medical Center, New York, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><affiliation><nlm:aff id="A17">Cedars-Sinai Medical Center, Los Angeles, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A18">UCLA School of Medicine, Los Angeles, CA, USA</nlm:aff></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><nlm:aff id="A19">Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA</nlm:aff></affiliation></author><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E" last="Compston">Juliet E. Compston</name><affiliation><nlm:aff id="A20">Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</nlm:aff></affiliation></author><author><name sortKey="Lacroix, Andrea" sort="Lacroix, Andrea" uniqKey="Lacroix A" first="Andrea" last="Lacroix">Andrea Lacroix</name><affiliation><nlm:aff id="A21">Fred Hutchinson Cancer Research Center, Seattle, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Gehlbach, Stephen" sort="Gehlbach, Stephen" uniqKey="Gehlbach S" first="Stephen" last="Gehlbach">Stephen Gehlbach</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21887705</idno><idno type="pmc">4881744</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881744</idno><idno type="RBID">PMC:4881744</idno><idno type="doi">10.1002/jbmr.503</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002036</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002036</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Predicting Fractures in an International Cohort using Risk Factor Algorithms, Without Bone Mineral Density</title><author><name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N" last="Sambrook">Philip N. Sambrook</name><affiliation><nlm:aff id="A1">University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Flahive, Julie" sort="Flahive, Julie" uniqKey="Flahive J" first="Julie" last="Flahive">Julie Flahive</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Hooven, Fred H" sort="Hooven, Fred H" uniqKey="Hooven F" first="Fred H" last="Hooven">Fred H. Hooven</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation><nlm:aff id="A3">Leuven University Division of Geriatric Medicine, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Chapurlat, Roland" sort="Chapurlat, Roland" uniqKey="Chapurlat R" first="Roland" last="Chapurlat">Roland Chapurlat</name><affiliation><nlm:aff id="A4">Division of Rheumatology, INSERM U831, Université de Lyon, Hôpital E. Herriot, Lyon, France</nlm:aff></affiliation></author><author><name sortKey="Lindsay, Robert" sort="Lindsay, Robert" uniqKey="Lindsay R" first="Robert" last="Lindsay">Robert Lindsay</name><affiliation><nlm:aff id="A5">Regional Bone Center, Helen Hayes Hospital, West Haverstraw, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Nguyen, Tuan V" sort="Nguyen, Tuan V" uniqKey="Nguyen T" first="Tuan V" last="Nguyen">Tuan V. Nguyen</name><affiliation><nlm:aff id="A6">Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent’s Hospital, Darlinghurst, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Perez">Adolfo Díez-Perez</name><affiliation><nlm:aff id="A7">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation><nlm:aff id="A8">Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</nlm:aff></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><nlm:aff id="A9">University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff></affiliation></author><author><name sortKey="Hosmer, David" sort="Hosmer, David" uniqKey="Hosmer D" first="David" last="Hosmer">David Hosmer</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></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><nlm:aff id="A10">Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</nlm:aff></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><nlm:aff id="A11">St Joseph’s Hospital, McMaster University, Hamilton, ON, Canada</nlm:aff></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><nlm:aff id="A12">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation><nlm:aff id="A13">MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK</nlm:aff></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation><nlm:aff id="A14">Paris Descartes University, Cochin Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation><nlm:aff id="A15">Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</nlm:aff></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><nlm:aff id="A16">Columbia University Medical Center, New York, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><affiliation><nlm:aff id="A17">Cedars-Sinai Medical Center, Los Angeles, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A18">UCLA School of Medicine, Los Angeles, CA, USA</nlm:aff></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><nlm:aff id="A19">Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA</nlm:aff></affiliation></author><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E" last="Compston">Juliet E. Compston</name><affiliation><nlm:aff id="A20">Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</nlm:aff></affiliation></author><author><name sortKey="Lacroix, Andrea" sort="Lacroix, Andrea" uniqKey="Lacroix A" first="Andrea" last="Lacroix">Andrea Lacroix</name><affiliation><nlm:aff id="A21">Fred Hutchinson Cancer Research Center, Seattle, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Gehlbach, Stephen" sort="Gehlbach, Stephen" uniqKey="Gehlbach S" first="Stephen" last="Gehlbach">Stephen Gehlbach</name><affiliation><nlm:aff id="A2">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</title><idno type="ISSN">0884-0431</idno><idno type="eISSN">1523-4681</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">Clinical risk factors are associated with increased probability of fracture in postmenopausal women. We sought to compare prediction models using self-reported clinical risk factors, excluding bone-mineral density (BMD), to predict incident fracture among postmenopausal women. The GLOW study enrolled women aged ≥55 years were seen at 723 primary care practices in 10 countries. The population comprised 19,586 women aged ≥60 years who were not receiving anti-osteoporosis medication and were followed annually for 2 years. Self-administered questionnaires were used to collect data on characteristics, fracture risk factors, previous fractures, and health status. The main outcome measure compares the c index for models using the WHO Fracture Risk (FRAX), the Garvan Fracture Risk Calculator (FRC), and a simple model using age and prior fracture. Over 2 years, 880 women reported incident fractures including 69 hip fractures, 468 “major fractures” (as defined by FRAX) and 583 “osteoporotic fractures” (as defined by FRC). Using baseline clinical risk factors, both FRAX and FRC showed moderate ability to correctly order hip fracture times (c index for hip fracture: 0.78 and 0.76, respectively). C indices for “major” and “osteoporotic” fractures showed lower values, at 0.61 and 0.64. Neither algorithm was better than the model based on age+fracture history alone (c index for hip fracture: 0.78). In conclusion, estimation of fracture risk in an international primary care population of postmenopausal women can be made using clinical risk factors alone, without BMD. However, more sophisticated models incorporating multiple clinical risk factors including falls were not superior to more parsimonious models in predicting future fracture in this population.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610640</journal-id><journal-id journal-id-type="pubmed-jr-id">104</journal-id><journal-id journal-id-type="nlm-ta">J Bone Miner Res</journal-id><journal-id journal-id-type="iso-abbrev">J. Bone Miner. Res.</journal-id><journal-title-group><journal-title>Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</journal-title></journal-title-group><issn pub-type="ppub">0884-0431</issn><issn pub-type="epub">1523-4681</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21887705</article-id><article-id pub-id-type="pmc">4881744</article-id><article-id pub-id-type="doi">10.1002/jbmr.503</article-id><article-id pub-id-type="manuscript">NIHMS787812</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Predicting Fractures in an International Cohort using Risk Factor Algorithms, Without Bone Mineral Density</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sambrook</surname><given-names>Philip N</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Flahive</surname><given-names>Julie</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Hooven</surname><given-names>Fred H</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Boonen</surname><given-names>Steven</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chapurlat</surname><given-names>Roland</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Lindsay</surname><given-names>Robert</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Nguyen</surname><given-names>Tuan V</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Díez-Perez</surname><given-names>Adolfo</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Pfeilschifter</surname><given-names>Johannes</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Greenspan</surname><given-names>Susan L</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Hosmer</surname><given-names>David</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Netelenbos</surname><given-names>J Coen</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A10">10</xref></contrib><contrib contrib-type="author"><name><surname>Adachi</surname><given-names>Jonathan D</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A11">11</xref></contrib><contrib contrib-type="author"><name><surname>Watts</surname><given-names>Nelson B</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A12">12</xref></contrib><contrib contrib-type="author"><name><surname>Cooper</surname><given-names>Cyrus</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Roux</surname><given-names>Christian</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A14">14</xref></contrib><contrib contrib-type="author"><name><surname>Rossini</surname><given-names>Maurizio</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A15">15</xref></contrib><contrib contrib-type="author"><name><surname>Siris</surname><given-names>Ethel S</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A16">16</xref></contrib><contrib contrib-type="author"><name><surname>Silverman</surname><given-names>Stuart</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A17">17</xref><xref ref-type="aff" rid="A18">18</xref></contrib><contrib contrib-type="author"><name><surname>Saag</surname><given-names>Kenneth G</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A19">19</xref></contrib><contrib contrib-type="author"><name><surname>Compston</surname><given-names>Juliet E</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A20">20</xref></contrib><contrib contrib-type="author"><name><surname>LaCroix</surname><given-names>Andrea</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A21">21</xref></contrib><contrib contrib-type="author"><name><surname>Gehlbach</surname><given-names>Stephen</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</aff><aff id="A2"><label>2</label>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</aff><aff id="A3"><label>3</label>Leuven University Division of Geriatric Medicine, Leuven, Belgium</aff><aff id="A4"><label>4</label>Division of Rheumatology, INSERM U831, Université de Lyon, Hôpital E. Herriot, Lyon, France</aff><aff id="A5"><label>5</label>Regional Bone Center, Helen Hayes Hospital, West Haverstraw, NY, USA</aff><aff id="A6"><label>6</label>Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent’s Hospital, Darlinghurst, Sydney, Australia</aff><aff id="A7"><label>7</label>Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain</aff><aff id="A8"><label>8</label>Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</aff><aff id="A9"><label>9</label>University of Pittsburgh, Pittsburgh, PA, USA</aff><aff id="A10"><label>10</label>Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</aff><aff id="A11"><label>11</label>St Joseph’s Hospital, McMaster University, Hamilton, ON, Canada</aff><aff id="A12"><label>12</label>Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, OH, USA</aff><aff id="A13"><label>13</label>MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK</aff><aff id="A14"><label>14</label>Paris Descartes University, Cochin Hospital, Paris, France</aff><aff id="A15"><label>15</label>Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</aff><aff id="A16"><label>16</label>Columbia University Medical Center, New York, NY, USA</aff><aff id="A17"><label>17</label>Cedars-Sinai Medical Center, Los Angeles, CA, USA</aff><aff id="A18"><label>18</label>UCLA School of Medicine, Los Angeles, CA, USA</aff><aff id="A19"><label>19</label>Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA</aff><aff id="A20"><label>20</label>Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</aff><aff id="A21"><label>21</label>Fred Hutchinson Cancer Research Center, Seattle, WA, USA</aff><author-notes><corresp id="CR1">Address correspondence to: Philip N Sambrook, MD, University of Sydney-Royal North Shore Hospital, Pacific Highway, St Leonards 2065, Sydney, NSW, Australia. <email>sambrook@med.usyd.edu.au</email>. Tel: 61.2.99267281.</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>19</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>11</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>5</month><year>2016</year></pub-date><volume>26</volume><issue>11</issue><fpage>2770</fpage><lpage>2777</lpage><pmc-comment>elocation-id from pubmed: 10.1002/jbmr.503</pmc-comment>
<abstract><p id="P1">Clinical risk factors are associated with increased probability of fracture in postmenopausal women. We sought to compare prediction models using self-reported clinical risk factors, excluding bone-mineral density (BMD), to predict incident fracture among postmenopausal women. The GLOW study enrolled women aged ≥55 years were seen at 723 primary care practices in 10 countries. The population comprised 19,586 women aged ≥60 years who were not receiving anti-osteoporosis medication and were followed annually for 2 years. Self-administered questionnaires were used to collect data on characteristics, fracture risk factors, previous fractures, and health status. The main outcome measure compares the c index for models using the WHO Fracture Risk (FRAX), the Garvan Fracture Risk Calculator (FRC), and a simple model using age and prior fracture. Over 2 years, 880 women reported incident fractures including 69 hip fractures, 468 “major fractures” (as defined by FRAX) and 583 “osteoporotic fractures” (as defined by FRC). Using baseline clinical risk factors, both FRAX and FRC showed moderate ability to correctly order hip fracture times (c index for hip fracture: 0.78 and 0.76, respectively). C indices for “major” and “osteoporotic” fractures showed lower values, at 0.61 and 0.64. Neither algorithm was better than the model based on age+fracture history alone (c index for hip fracture: 0.78). In conclusion, estimation of fracture risk in an international primary care population of postmenopausal women can be made using clinical risk factors alone, without BMD. However, more sophisticated models incorporating multiple clinical risk factors including falls were not superior to more parsimonious models in predicting future fracture in this population.</p></abstract><kwd-group><kwd>FRACTURE</kwd><kwd>RISK FACTORS</kwd><kwd>POSTMENOPAUSAL WOMEN</kwd><kwd>PREDICTION</kwd><kwd>MODELS</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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