Article: Discriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women

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TitleDiscriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women
AuthorsCheung, EYN3
Bow, CH2
Cheung, CL1 2
Soong, C2
Yeung, S2
Loong, C2
Kung, A2
Issue Date2012
PublisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198
CitationOsteoporosis International, 2012, v. 23 n. 3, p. 871-878 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00198-011-1647-5
AbstractWe followed 2,266 postmenopausal Chinese women for 4.5 years to determine which model best predicts osteoporotic fracture. A model that contains ethnic-specific risk factors, some of which reflect frailty, performed as well as or better than the well-established FRAX model. Introduction: Clinical risk assessment, with or without T-score, can predict fractures in Chinese postmenopausal women although it is unknown which combination of clinical risk factors is most effective. This prospective study sought to compare the accuracy for fracture prediction using various models including FRAX, our ethnic-specific clinical risk factors (CRF) and other simple models. Methods: This study is part of the Hong Kong Osteoporosis Study. A total of 2,266 treatment naïve postmenopausal women underwent clinical risk factor and bone mineral density assessment. Subjects were followed up for outcome of major osteoporotic fracture and receiver operating characteristic (ROC) curves for different models were compared. The percentage of subjects in different quartiles of risk according to various models who actually fractured was also compared. Results: The mean age at baseline was 62.1 ± 8.5 years and mean follow-up time was 4.5 ± 2.8 years. A total of 106 new major osteoporotic fractures were reported, of which 21 were hip fractures. Ethnic-specific CRF with T-score performed better than FRAX with T-score (based on both Chinese normative and National Health and Nutrition Examination Survey (NHANES) databases) in terms of AUC comparison for prediction of major osteoporotic fracture. The two models were similar in hip fracture prediction. The ethnic-specific CRF model had a 10% higher sensitivity than FRAX at a specificity of 0.8 or above. Conclusion: CRF related to frailty and differences in lifestyle between populations are likely to be important in fracture prediction. Further work is required to determine which and how CRF can be applied to develop a fracture prediction model in our population. © 2011 International Osteoporosis Foundation and National Osteoporosis Foundation.
ISSN0937-941X
2011 Impact Factor: 4.58
2011 SCImago Journal Rankings: 0.341
DOIhttp://dx.doi.org/10.1007/s00198-011-1647-5
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorCheung, EYN
dc.contributor.authorBow, CH
dc.contributor.authorCheung, CL
dc.contributor.authorSoong, C
dc.contributor.authorYeung, S
dc.contributor.authorLoong, C
dc.contributor.authorKung, A
dc.date.accessioned2012-09-05T05:31:40Z
dc.date.available2012-09-05T05:31:40Z
dc.date.issued2012
dc.description.abstractWe followed 2,266 postmenopausal Chinese women for 4.5 years to determine which model best predicts osteoporotic fracture. A model that contains ethnic-specific risk factors, some of which reflect frailty, performed as well as or better than the well-established FRAX model. Introduction: Clinical risk assessment, with or without T-score, can predict fractures in Chinese postmenopausal women although it is unknown which combination of clinical risk factors is most effective. This prospective study sought to compare the accuracy for fracture prediction using various models including FRAX, our ethnic-specific clinical risk factors (CRF) and other simple models. Methods: This study is part of the Hong Kong Osteoporosis Study. A total of 2,266 treatment naïve postmenopausal women underwent clinical risk factor and bone mineral density assessment. Subjects were followed up for outcome of major osteoporotic fracture and receiver operating characteristic (ROC) curves for different models were compared. The percentage of subjects in different quartiles of risk according to various models who actually fractured was also compared. Results: The mean age at baseline was 62.1 ± 8.5 years and mean follow-up time was 4.5 ± 2.8 years. A total of 106 new major osteoporotic fractures were reported, of which 21 were hip fractures. Ethnic-specific CRF with T-score performed better than FRAX with T-score (based on both Chinese normative and National Health and Nutrition Examination Survey (NHANES) databases) in terms of AUC comparison for prediction of major osteoporotic fracture. The two models were similar in hip fracture prediction. The ethnic-specific CRF model had a 10% higher sensitivity than FRAX at a specificity of 0.8 or above. Conclusion: CRF related to frailty and differences in lifestyle between populations are likely to be important in fracture prediction. Further work is required to determine which and how CRF can be applied to develop a fracture prediction model in our population. © 2011 International Osteoporosis Foundation and National Osteoporosis Foundation.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationOsteoporosis International, 2012, v. 23 n. 3, p. 871-878 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00198-011-1647-5
dc.identifier.citeulike9317966
dc.identifier.doihttp://dx.doi.org/10.1007/s00198-011-1647-5
dc.identifier.epage878
dc.identifier.issn0937-941X
2011 Impact Factor: 4.58
2011 SCImago Journal Rankings: 0.341
dc.identifier.issue3
dc.identifier.pmid21562875
dc.identifier.scopuseid_2-s2.0-84857440529
dc.identifier.spage871
dc.identifier.urihttp://hdl.handle.net/10722/163459
dc.identifier.volume23
dc.languageeng
dc.publisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198
dc.publisher.placeUnited Kingdom
dc.relation.ispartofOsteoporosis International
dc.relation.referencesReferences in Scopus
dc.subject.meshAbsorptiometry, Photon - Methods
dc.subject.meshAdult
dc.subject.meshAge Factors
dc.subject.meshAged
dc.subject.meshAged, 80 And Over
dc.subject.meshAlgorithms
dc.subject.meshAsian Continental Ancestry Group - Psychology - Statistics & Numerical Data
dc.subject.meshBone Density - Physiology
dc.subject.meshCohort Studies
dc.subject.meshFemale
dc.subject.meshFemur Neck - Physiopathology
dc.subject.meshHip Fractures - Epidemiology - Etiology - Physiopathology
dc.subject.meshHong Kong - Epidemiology
dc.subject.meshHumans
dc.subject.meshLife Style - Ethnology
dc.subject.meshLumbar Vertebrae - Physiopathology
dc.subject.meshMiddle Aged
dc.subject.meshOsteoporosis, Postmenopausal - Complications - Epidemiology - Physiopathology
dc.subject.meshOsteoporotic Fractures - Epidemiology - Etiology - Physiopathology
dc.subject.meshRisk Assessment - Methods
dc.titleDiscriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women
dc.typeArticle
Author Affiliations
  1. Harvard Medical School
  2. The University of Hong Kong
  3. United Christian Hospital Hong Kong