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

TitleDiscriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women
Authors
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
Citation
Osteoporosis International, 2012, v. 23 n. 3, p. 871-878 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/163459
ISSN
2014 Impact Factor: 4.169
2014 SCImago Journal Rankings: 1.706
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, EYNen_HK
dc.contributor.authorBow, CHen_HK
dc.contributor.authorCheung, CLen_HK
dc.contributor.authorSoong, Cen_HK
dc.contributor.authorYeung, Sen_HK
dc.contributor.authorLoong, Cen_HK
dc.contributor.authorKung, Aen_HK
dc.date.accessioned2012-09-05T05:31:40Z-
dc.date.available2012-09-05T05:31:40Z-
dc.date.issued2012en_HK
dc.identifier.citationOsteoporosis International, 2012, v. 23 n. 3, p. 871-878en_HK
dc.identifier.issn0937-941Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/163459-
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.en_HK
dc.languageengen_US
dc.publisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198en_HK
dc.relation.ispartofOsteoporosis Internationalen_HK
dc.subjectChinese postmenopausal womenen_HK
dc.subjectDiscriminative valueen_HK
dc.subjectEthnic-specific clinic risk factorsen_HK
dc.subjectFracture predictionen_HK
dc.subjectFRAXen_HK
dc.subjectOsteoporotic fractureen_HK
dc.subject.meshAbsorptiometry, Photon - Methodsen_US
dc.subject.meshAdulten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAlgorithmsen_US
dc.subject.meshAsian Continental Ancestry Group - Psychology - Statistics & Numerical Dataen_US
dc.subject.meshBone Density - Physiologyen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshFemur Neck - Physiopathologyen_US
dc.subject.meshHip Fractures - Epidemiology - Etiology - Physiopathologyen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLife Style - Ethnologyen_US
dc.subject.meshLumbar Vertebrae - Physiopathologyen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOsteoporosis, Postmenopausal - Complications - Epidemiology - Physiopathologyen_US
dc.subject.meshOsteoporotic Fractures - Epidemiology - Etiology - Physiopathologyen_US
dc.subject.meshRisk Assessment - Methodsen_US
dc.titleDiscriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal womenen_HK
dc.typeArticleen_HK
dc.identifier.emailCheung, CL: lung1212@hku.hken_HK
dc.identifier.emailKung, A: awckung@hku.hken_HK
dc.identifier.authorityCheung, CL=rp01749en_HK
dc.identifier.authorityKung, A=rp00368en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s00198-011-1647-5en_HK
dc.identifier.pmid21562875-
dc.identifier.scopuseid_2-s2.0-84857440529en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84857440529&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume23en_HK
dc.identifier.issue3en_HK
dc.identifier.spage871en_HK
dc.identifier.epage878en_HK
dc.identifier.isiWOS:000300251200008-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheung, EYN=9942706500en_HK
dc.identifier.scopusauthoridBow, CH=36055977600en_HK
dc.identifier.scopusauthoridCheung, CL=14520953400en_HK
dc.identifier.scopusauthoridSoong, C=36769165800en_HK
dc.identifier.scopusauthoridYeung, S=25923636600en_HK
dc.identifier.scopusauthoridLoong, C=36768353300en_HK
dc.identifier.scopusauthoridKung, A=7102322339en_HK
dc.identifier.citeulike9317966-

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