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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, CH1
Cheung, CL1 2
Soong, C1
Yeung, S1
Loong, C1
Kung, A1
 
KeywordsChinese postmenopausal women
Discriminative value
Ethnic-specific clinic risk factors
Fracture prediction
FRAX
Osteoporotic fracture
 
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
2013 Impact Factor: 4.165
 
DOIhttp://dx.doi.org/10.1007/s00198-011-1647-5
 
ReferencesReferences in Scopus
 
DC FieldValue
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
2013 Impact Factor: 4.165
 
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.subjectChinese postmenopausal women
 
dc.subjectDiscriminative value
 
dc.subjectEthnic-specific clinic risk factors
 
dc.subjectFracture prediction
 
dc.subjectFRAX
 
dc.subjectOsteoporotic fracture
 
dc.titleDiscriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Harvard Medical School
  3. United Christian Hospital Hong Kong