Ten-year probability of osteoporotic fracture in 2012 Polish women assessed by FRAX and nomogram by Nguyen et al.—Conformity between methods and their clinical utility

Pluskiewicz, Wojciech; Adamczyk, Piotr; Franek, Edward; Leszczyński, Piotr; Sewerynek, Ewa; Wichrowska, Hanna; Napiórkowska, Luiza; Kostyk, Tomasz; Stuss, Michał; Stępień-Kłos, Wioletta; Gołba, Krzysztof S.; Drozdzowska, Bogna

doi:10.1016/j.bone.2010.02.012

Cited by 60 publications

(39 citation statements)

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“…In this context, an AUC of greater than 0.8 might (rather arbitrarily) signify a good test, but the same criterion is not appropriate for predictive algorithms. A frequent abuse of ROC curves arises from a mistaken belief [2][3][4][5][6][7][8]10] that they capture all that is required to judge the performance characteristics of a test. This ignores three fundamental limitations of such analyses, namely, & a lack of sensitivity of ROC analyses to additional variables, & the inappropriateness of comparing AUCs across studies and & the inability of ROC to determine the use of a clinical tool to identify risk categories for intervention.…”

Section: Limitations and Abuse Of Roc Analysesmentioning

confidence: 99%

“…However, flaws may arise when FRAX probabilities are compared with observed incidences [1,3,4,6,8,10,23]. For example, two papers [3,4], undertaking such comparisons, suggested that FRAX overestimated the incidence of hip fracture when BMD was not entered into the model and underestimated hip fracture risk when BMD was included (Table 5).…”

Section: Comparing Incidences and Probabilitiesmentioning

confidence: 99%

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Pitfalls in the external validation of FRAX

et al. 2011

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Section: Limitations and Abuse Of Roc Analysesmentioning

confidence: 99%

Section: Comparing Incidences and Probabilitiesmentioning

confidence: 99%

Pitfalls in the external validation of FRAX

et al. 2011

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“…Several factors influence osteoporosis, such as endocrine factors, genetic factors, and nutritional factors (in youth, the nutrients are used for synthesis of bone matrix, which is critical for bone growth) Johansson et al, 2010;Pluskiewicz et al, 2010). Alendronate promotes bone regeneration and healing of bone tissue damage by decreasing the number of osteoclasts and increasing the number of osteoblasts, which is observed in osteoporosis (Pressman et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Effects of alendronate on osteoporosis treatment and levels of related cytokines

2017

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ABSTRACT. Alendronate regulates the activity of osteoclasts and healing of osteoporosis. This study investigated the effect of alendronate on bone healing and changes in the levels of cytokines. Bilateral ovaries of 10 adult female rabbits were removed surgically in aseptic condition to establish the animal model of osteoporosis. Five rabbits in group A were treated with alendronate (1.15 mg·kg -1 ·week -1 ) once a week by a stomach tube, whereas the remaining 5 in group B were treated with physiological saline. The success of the animal model establishment and the efficacy of alendronate treatment were evaluated by the sports ability score and the Basso, Beattie, and Bresnahan (BBB) score; the healing degree of osteoporosis was determined by X-ray analysis and measurement of biomechanical properties; the changes in the levels of related cytokines were measured by enzyme-linked immunosorbent assay (ELISA) and immunohistochemical staining. Treatment improved dyskinesia of the animals in group A than that in group B, with significant improvement occurring in the 4th week of treatment. The BBB score of the group A animals revealed movements similar to normal, but that of the group B animals exhibited significant motor disturbance (P < 0.01). X-ray examination showed that with time, the X-ray ratings increased. Measurement of the biomechanical properties further showed that alendronate had a positive effect on osteoporosis healing. The results of ELISA and immunohistochemistry showed that the levels of ALP, BMP-2, bFGF, and IGF-1 were upregulated in group A. In conclusion, alendronate accelerated osteoporosis healing probably via certain cytokine-related mechanism.

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“…The prediction accuracy of FRAX was examined in several studies and FRAX may underestimate the risk of fractures [9,10]. When compared to other risk assessment methods, FRAX performs similarly or better than other simpler methods (based on age, previous fracture or BMD), outcomes on comparison with other calculators are inconsistent [11][12][13][14][15][16][17][18]. However, construction on multiple population cohorts, external validation, applicability to various countries, output as absolute risk and inclusion of risk factors amenable to treatment are major advantages of FRAX compared to other risk assessment tools [19,20].…”

Section: Discussionmentioning

confidence: 99%