Prediction of major osteoporotic and hip fractures in Australian men using FRAX scores adjusted with trabecular bone score View Full Text


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Article Info

DATE

2018-01

AUTHORS

K. L. Holloway, M. Mohebbi, A. G. Betson, D. Hans, N. K. Hyde, S. L. Brennan-Olsen, M. A. Kotowicz, J. A. Pasco

ABSTRACT

There was no significant difference between the areas under receiver operating characteristics (AUROCs) and diagnostic indexes (sensitivity, specificity, positive predictive value, negative predictive value) for either major osteoporotic or hip fracture FRAX scores when comparing the unadjusted and trabecular bone score (TBS)-adjusted scores. INTRODUCTION: FRAX 10-year probability of fracture can be calculated with adjustment for the TBS. Studies have shown that TBS can improve FRAX assessments in some populations. This study aimed to determine if TBS-adjusted FRAX score is better than the unadjusted score for predicting major osteoporotic fracture (MOF) and hip fracture in Australian men. METHODS: This study involved 591 men aged 40-90 years, enrolled in the Geelong Osteoporosis Study. Incident MOF (n = 50) and hip fractures (n = 14) were ascertained using radiological reports. Median follow-up time was 9.5 years (IQR7.5-11.4). Diagnostic indexes were calculated using cut points of ≥20% for MOF and ≥3% for the hip. AUROC curves were also determined for adjusted and unadjusted scores as continuous variables. RESULTS: Sensitivity was higher in the TBS-adjusted scores (MOF 4%, hip 78.6%) than the unadjusted scores (MOF 2%, hip 57.1%), with a decrease in specificity (MOF 98.9 vs 99.3%; hip 79.9 vs 83.9%). When considering TBS-adjusted and unadjusted FRAX as continuous scores, AUROCs were 0.738 and 0.740, respectively, for MOF and 0.849 and 0.848 for the hip. CONCLUSIONS: Prediction of fractures by MOF or hip FRAX was not substantially improved by TBS adjustment. There was no difference in AUROCs or diagnostic indexes for cut-off points of ≥20 for MOF and ≥3% for hip FRAX. More... »

PAGES

101-108

References to SciGraph publications

  • 2015-06. Trabecular bone score may improve FRAX® prediction accuracy for major osteoporotic fractures in elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study in OSTEOPOROSIS INTERNATIONAL
  • 2011-09. Interpretation and use of FRAX in clinical practice in OSTEOPOROSIS INTERNATIONAL
  • 2014-09. Lumbar spine texture enhances 10-year fracture probability assessment in OSTEOPOROSIS INTERNATIONAL
  • 2014-03. Fracture risk among older men: osteopenia and osteoporosis defined using cut-points derived from female versus male reference data in OSTEOPOROSIS INTERNATIONAL
  • 2014-01. FRAX provides robust fracture prediction regardless of socioeconomic status in OSTEOPOROSIS INTERNATIONAL
  • 2015-02. Is There an Interaction Between Socioeconomic Status and FRAX 10-Year Fracture Probability Determined With and Without Bone Density Measures? Data from the Geelong Osteoporosis Study of Female Cohort in CALCIFIED TISSUE INTERNATIONAL
  • 2014-11. Utility of the trabecular bone score (TBS) in secondary osteoporosis in ENDOCRINE
  • 2006-09. The population burden of fractures originates in women with osteopenia, not osteoporosis in OSTEOPOROSIS INTERNATIONAL
  • 2015-12. The Epidemiology of Incident Fracture from Cradle to Senescence in CALCIFIED TISSUE INTERNATIONAL
  • 2015-06. Adjusting Fracture Probability by Trabecular Bone Score in CALCIFIED TISSUE INTERNATIONAL
  • 2013-09. The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex vivo study in OSTEOPOROSIS INTERNATIONAL
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    http://scigraph.springernature.com/pub.10.1007/s00198-017-4226-6

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    https://www.ncbi.nlm.nih.gov/pubmed/28940052


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    24 https://doi.org/10.1093/ije/dyr148
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    31 schema:description There was no significant difference between the areas under receiver operating characteristics (AUROCs) and diagnostic indexes (sensitivity, specificity, positive predictive value, negative predictive value) for either major osteoporotic or hip fracture FRAX scores when comparing the unadjusted and trabecular bone score (TBS)-adjusted scores. INTRODUCTION: FRAX 10-year probability of fracture can be calculated with adjustment for the TBS. Studies have shown that TBS can improve FRAX assessments in some populations. This study aimed to determine if TBS-adjusted FRAX score is better than the unadjusted score for predicting major osteoporotic fracture (MOF) and hip fracture in Australian men. METHODS: This study involved 591 men aged 40-90 years, enrolled in the Geelong Osteoporosis Study. Incident MOF (n = 50) and hip fractures (n = 14) were ascertained using radiological reports. Median follow-up time was 9.5 years (IQR7.5-11.4). Diagnostic indexes were calculated using cut points of ≥20% for MOF and ≥3% for the hip. AUROC curves were also determined for adjusted and unadjusted scores as continuous variables. RESULTS: Sensitivity was higher in the TBS-adjusted scores (MOF 4%, hip 78.6%) than the unadjusted scores (MOF 2%, hip 57.1%), with a decrease in specificity (MOF 98.9 vs 99.3%; hip 79.9 vs 83.9%). When considering TBS-adjusted and unadjusted FRAX as continuous scores, AUROCs were 0.738 and 0.740, respectively, for MOF and 0.849 and 0.848 for the hip. CONCLUSIONS: Prediction of fractures by MOF or hip FRAX was not substantially improved by TBS adjustment. There was no difference in AUROCs or diagnostic indexes for cut-off points of ≥20 for MOF and ≥3% for hip FRAX.
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