Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW).
CONTEXT: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. OBJECTIVE: The objective of the study was to impr...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Endocrine Society
2014
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| _version_ | 1797082773082603520 |
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| author | FitzGerald, G Compston, J Chapurlat, R Pfeilschifter, J Cooper, C Hosmer, D Adachi, J Anderson, F Díez-Pérez, A Greenspan, S Netelenbos, J Nieves, J Rossini, M Watts, N Hooven, F LaCroix, A March, L Roux, C Saag, K Siris, E Silverman, S Gehlbach, S |
| author_facet | FitzGerald, G Compston, J Chapurlat, R Pfeilschifter, J Cooper, C Hosmer, D Adachi, J Anderson, F Díez-Pérez, A Greenspan, S Netelenbos, J Nieves, J Rossini, M Watts, N Hooven, F LaCroix, A March, L Roux, C Saag, K Siris, E Silverman, S Gehlbach, S |
| author_sort | FitzGerald, G |
| collection | OXFORD |
| description | CONTEXT: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. OBJECTIVE: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. DESIGN: This was a prospective, observational cohort study. SETTING: The study was conducted at primary care practices in 10 countries. PATIENTS: Women aged 55 years or older participated in the study. INTERVENTION: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. MAIN OUTCOME MEASURE: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. RESULTS: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The unadjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. CONCLUSIONS: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model. |
| first_indexed | 2024-03-07T01:32:35Z |
| format | Journal article |
| id | oxford-uuid:94178b6a-c2a9-4f36-bcdc-953b8263a489 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:32:35Z |
| publishDate | 2014 |
| publisher | Endocrine Society |
| record_format | dspace |
| spelling | oxford-uuid:94178b6a-c2a9-4f36-bcdc-953b8263a4892022-03-26T23:36:54ZEmpirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW).Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:94178b6a-c2a9-4f36-bcdc-953b8263a489EnglishSymplectic Elements at OxfordEndocrine Society2014FitzGerald, GCompston, JChapurlat, RPfeilschifter, JCooper, CHosmer, DAdachi, JAnderson, FDíez-Pérez, AGreenspan, SNetelenbos, JNieves, JRossini, MWatts, NHooven, FLaCroix, AMarch, LRoux, CSaag, KSiris, ESilverman, SGehlbach, SCONTEXT: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. OBJECTIVE: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. DESIGN: This was a prospective, observational cohort study. SETTING: The study was conducted at primary care practices in 10 countries. PATIENTS: Women aged 55 years or older participated in the study. INTERVENTION: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. MAIN OUTCOME MEASURE: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. RESULTS: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The unadjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. CONCLUSIONS: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model. |
| spellingShingle | FitzGerald, G Compston, J Chapurlat, R Pfeilschifter, J Cooper, C Hosmer, D Adachi, J Anderson, F Díez-Pérez, A Greenspan, S Netelenbos, J Nieves, J Rossini, M Watts, N Hooven, F LaCroix, A March, L Roux, C Saag, K Siris, E Silverman, S Gehlbach, S Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title | Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title_full | Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title_fullStr | Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title_full_unstemmed | Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title_short | Empirically based composite fracture prediction model from the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW). |
| title_sort | empirically based composite fracture prediction model from the global longitudinal study of osteoporosis in postmenopausal women glow |
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