Validation of a 5-year risk score of hip fracture in postmenopausal women. The Danish Nurse Cohort Study

Hundrup, Yrsa Andersen; Jacobsen, Rikke Kart; Andreasen, Anne Helms; Davidsen, Michael; Obel, Erik B.; Abrahamsen, Bo

doi:10.1007/s00198-010-1176-7

Cited by 9 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other Fracture Risk Assessment Instruments | Across 9 fracture risk assessment instruments (the Women's Health Initiative algorithm, 63 OST, 65 Simple Calculated Osteoporosis Risk Estimation, 67 Fracture and Immobilization Score, 68 Fracture Risk Score, 70 Fracture Risk Calculator, 71 ORAI, 74 QFracture, 60 and Osteoporosis Index of Risk), 75 AUC estimates ranged from 0.53 to 0.82 for major osteoporotic fracture 8,36,46,47,66 and from 0.80 to 0.89 for hip fracture. 8,63,64,73 A tenth instrument, the Canadian Association of Radiologists and Osteoporosis Canada, did not provide AUC estimates 76 but reported a sensitivity for predicting fracture of 0.54 (95% CI, 0.52-0.56) among women and 0.31 (95% CI, 0.24-0.38) among men. 77 The reported specificities were 0.75 (95% CI, 0.74-0.75) for women and 0.86 (0.85-0.87) for men.…”

Section: Predicting Osteoporotic Fractures Clinical Risk Assessmentsmentioning

confidence: 99%

Screening to Prevent Osteoporotic Fractures

Viswanathan

Reddy

Berkman

et al. 2018

JAMA

156

134

View full text Add to dashboard Cite

show abstract

Section: Predicting Osteoporotic Fractures Clinical Risk Assessmentsmentioning

confidence: 99%

Screening to Prevent Osteoporotic Fractures

Viswanathan

Reddy

Berkman

et al. 2018

JAMA

156

134

View full text Add to dashboard Cite

show abstract

“…Self-reported (2), radiographs (1) No AUC WHI (38) 2 (38,117) questionnaires. Missing data were accounted for in 19 studies.…”

Section: Nsmentioning

confidence: 99%

Risk assessment tools to identify women with increased risk of osteoporotic fracture: Complexity or simplicity? A systematic review

Rubin

Holmberg

Hermann

et al. 2013

Journal of Bone and Mineral Research

164

130

View full text Add to dashboard Cite

A huge number of risk assessment tools have been developed. Far from all have been validated in external studies, more of them have absence of methodological and transparent evidence, and few are integrated in national guidelines. Therefore, we performed a systematic review to provide an overview of existing valid and reliable risk assessment tools for prediction of osteoporotic fractures. Additionally, we aimed to determine if the performance of each tool was sufficient for practical use, and last, to examine whether the complexity of the tools influenced their discriminative power. We searched PubMed, Embase, and Cochrane databases for papers and evaluated these with respect to methodological quality using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) checklist. A total of 48 tools were identified; 20 had been externally validated, however, only six tools had been tested more than once in a population-based setting with acceptable methodological quality. None of the tools performed consistently better than the others and simple tools (i.e., the Osteoporosis Self-assessment

show abstract

Performance of risk assessment instruments for predicting osteoporotic fracture risk: a systematic review

et al. 2013

View full text Add to dashboard Cite

Summary We systematically reviewed the literature on the performance of osteoporosis absolute fracture risk assessment instruments. Relatively few studies have evaluated the calibration of instruments in populations separate from their development cohorts, and findings are mixed. Many studies had methodological limitations making susceptibility to bias a concern. Introduction The aim of this study was to systematically review the literature on the performance of osteoporosis clinical fracture risk assessment instruments for predicting absolute fracture risk, or calibration, in populations other than their derivation cohorts. Methods We performed a systematic review, and MEDLINE, Embase, Cochrane Library, and multiple other literature sources were searched. Inclusion and exclusion criteria were applied and data extracted, including information about study participants, study design, potential sources of bias, and predicted and observed fracture probabilities. Results A total of 19,949 unique records were identified for review. Fourteen studies met inclusion criteria. There was substantial heterogeneity among included studies. Six studies assessed the WHO's Fracture Risk Assessment (FRAX) instrument in five separate cohorts, and a variety of risk assessment instruments were evaluated in the remainder of the studies. Approximately half found good instrument calibration, with observed fracture probabilities being close to predicted probabilities for different risk categories. Studies that assessed the calibration of FRAX found mixed performance in different populations. A similar proportion of studies that evaluated simple risk assessment instruments (≤5 variables) found good calibration when compared with studies that assessed complex instruments (>5 variables). Many studies had methodological features making them susceptible to bias. Conclusions Few studies have evaluated the performance or calibration of osteoporosis fracture risk assessment instruments in populations separate from their development cohorts. Findings are mixed, and many studies had methodological limitations making susceptibility to bias a possibility, raising concerns about use of these tools outside of the original derivation cohorts. Further studies are needed to assess the calibration of instruments in different populations prior to widespread use.

show abstract

Validation of a 5-year risk score of hip fracture in postmenopausal women. The Danish Nurse Cohort Study

Abstract: While the WHI algorithm was well calibrated on the Danish population, the clinical utility of the WHI algorithm in Danish postmenopausal women was limited by poor sensitivity at common decision-making thresholds and suboptimal in non-HT-users.

Cited by 9 publications

References 22 publications

Screening to Prevent Osteoporotic Fractures

Screening to Prevent Osteoporotic Fractures

Risk assessment tools to identify women with increased risk of osteoporotic fracture: Complexity or simplicity? A systematic review

Performance of risk assessment instruments for predicting osteoporotic fracture risk: a systematic review

Contact Info

Product

Resources

About