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https://www.readbyqxmd.com/read/27801641/a-systematic-review-and-economic-evaluation-of-bisphosphonates-for-the-prevention-of-fragility-fractures
#1
Sarah Davis, Marrissa Martyn-St James, Jean Sanderson, John Stevens, Edward Goka, Andrew Rawdin, Susi Sadler, Ruth Wong, Fiona Campbell, Matt Stevenson, Mark Strong, Peter Selby, Neil Gittoes
BACKGROUND: Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. OBJECTIVES: To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax(®) and Fosamax(®) Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel(®) and Actonel Once a Week(®), Warner Chilcott UK Ltd), ibandronic acid (Bonviva(®), Roche Products Ltd) and zoledronic acid (Aclasta(®), Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27429561/raman-spectroscopic-analysis-of-fingernail-clippings-can-help-differentiate-between-postmenopausal-women-who-have-and-have-not-suffered-a-fracture
#2
James R Beattie, Niamh M Cummins, Clare Caraher, Olive M O'Driscoll, Aruna T Bansal, Richard Eastell, Stuart H Ralston, Michael D Stone, Gill Pearson, Mark R Towler
Raman spectroscopy was applied to nail clippings from 633 postmenopausal British and Irish women, from six clinical sites, of whom 42% had experienced a fragility fracture. The objective was to build a prediction algorithm for fracture using data from four sites (known as the calibration set) and test its performance using data from the other two sites (known as the validation set). Results from the validation set showed that a novel algorithm, combining spectroscopy data with clinical data, provided area under the curve (AUC) of 74% compared to an AUC of 60% from a reduced QFracture score (a clinically accepted risk calculator) and 61% from the dual-energy X-ray absorptiometry T-score, which is in current use for the diagnosis of osteoporosis...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/26792635/predicting-fracture-risk-in-osteoporosis-the-use-of-fracture-prediction-tools-in-an-osteoporosis-clinic-population
#3
Darren Aw, Jennifer Thain, Aamer Ali, Thanda Aung, Wei Mei Chua, Opinder Sahota, Namal Weerasuriya, Lindsey Marshall, Fiona Kearney, Tahir Masud
BACKGROUND: In the UK, the National Institute for Health and Care Excellence recommends either fracture risk assessment tool (FRAX) or QFracture to estimate the 10 year fracture risk of individuals. However, it is not known how these tools compare in determining risk and subsequent treatment using set intervention thresholds or guidelines. METHODS: The 10 year major osteoporotic (MO) and hip (HI) fracture risks were calculated for 100 women attending osteoporosis clinic in 2010 using FRAX and QFracture, and subsequent agreement to treatment between the tools was looked at using National Osteoporosis Foundation and National Bone Health Alliance thresholds (FRAX-20/3 and QFracture 20/3)...
May 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/26650822/sign-guidelines-for-scotland-bmd-versus-frax-versus-qfracture
#4
REVIEW
John A Kanis, Juliet Compston, Cyrus Cooper, Nicholas C Harvey, Helena Johansson, Anders Odén, Eugene V McCloskey
Scottish Intercollegiate Guidelines Network (SIGN) recently issued guidance on the management of osteoporosis and the prevention of fragility fractures. The aim of this paper was to critically review the guidance. The SIGN guidance utilises risk factors for fracture as an initial step for assessment, but recommends treatment only in individuals with a T-score of -2.5. There are many problems with the sole use of BMD as the sole gateway to treatment. Moreover, the assessment tools to determine risk (FRAX or QFracture) are not designed to detect osteoporosis but rather fracture risk...
May 2016: Calcified Tissue International
https://www.readbyqxmd.com/read/26248637/the-accuracy-of-osteoporotic-fracture-risk-prediction-tools-a-systematic-review-and-meta-analysis
#5
REVIEW
Andréa Marques, Ricardo J O Ferreira, Eduardo Santos, Estíbaliz Loza, Loreto Carmona, José António Pereira da Silva
OBJECTIVES: To identify and synthesise the best available evidence on the accuracy of the currently available tools for predicting fracture risk. METHODS: We systematically searched PubMed MEDLINE, Embase and Cochrane databases to 2014. Two reviewers independently selected articles, collected data from studies, and carried out a hand search of the references of the included studies. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) checklist was used, and the primary outcome was the area under the curve (AUC) and 95% CIs, obtained from receiver operating characteristic (ROC) analyses...
November 2015: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/25650086/fragility-fracture-recent-developments-in-risk-assessment
#6
REVIEW
Terry J Aspray
More than half of older women who sustain a fragility fracture do not have osteoporosis by World Health Organization (WHO) bone mineral density (BMD) criteria; and, while BMD has been used to assess fracture risk for over 30 years, a range of other skeletal and nonskeletal clinical risk factors (CRFs) for fracture have been recognized. More than 30 assessment tools using CRFs have been developed, some predicting fracture risk and others low BMD alone. Recent systematic reviews have reported that many tools have not been validated against fracture incidence, and that the complexity of tools and the number of CRFs included do not ensure best performance with poor assessment of (internal or comparative) validity...
February 2015: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/25236847/assessment-and-management-of-fracture-risk-in-patients-with-parkinson-s-disease
#7
Veronica Lyell, Emily Henderson, Mark Devine, Celia Gregson
Parkinson's disease (PD) is associated with substantially increased fracture risk, particularly hip fracture, which can occur relatively early in the course of PD. Despite this, current national clinical guidelines for PD fail to adequately address fracture risk assessment or the management of bone health. We appraise the evidence supporting bone health management in PD and propose a PD-specific algorithm for the fracture risk assessment and the management of bone health in patients with PD and related movement disorders...
January 2015: Age and Ageing
https://www.readbyqxmd.com/read/25168040/the-performance-of-seven-qprediction-risk-scores-in-an-independent-external-sample-of-patients-from-general-practice-a-validation-study
#8
Julia Hippisley-Cox, Carol Coupland, Peter Brindle
OBJECTIVES: To validate the performance of a set of risk prediction algorithms developed using the QResearch database, in an independent sample from general practices contributing to the Clinical Research Data Link (CPRD). SETTING: Prospective open cohort study using practices contributing to the CPRD database and practices contributing to the QResearch database. PARTICIPANTS: The CPRD validation cohort consisted of 3.3 million patients, aged 25-99 years registered at 357 general practices between 1 Jan 1998 and 31 July 2012...
2014: BMJ Open
https://www.readbyqxmd.com/read/24985401/predictors-of-new-fragility-fractures-after-diagnosis-of-indolent-systemic-mastocytosis
#9
Eveline van der Veer, Suzanne Arends, Sjoukje van der Hoek, Joris B Versluijs, Jan G R de Monchy, Joanna N G Oude Elberink, Jasper J van Doormaal
BACKGROUND: Fragility fractures (FFxs) and osteoporosis occur frequently in patients with indolent systemic mastocytosis (ISM), even before 50 years of age. OBJECTIVE: We sought to develop a prediction model to identify individual patients with ISM at risk of new FFxs. METHODS: Data on lifetime fractures and trauma circumstances were collected from vertebral morphometry, patients' records, and questionnaires. Clinical, lifestyle, and bone characteristics were measured...
December 2014: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/24718980/a-service-development-study-of-the-assessment-and-management-of-fracture-risk-in-parkinson-s-disease
#10
Samuel Shribman, Kelli M Torsney, Alastair J Noyce, Gavin Giovannoni, Julian Fearnley, Ruth Dobson
Parkinson's disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated...
June 2014: Journal of Neurology
https://www.readbyqxmd.com/read/24367877/assessing-fracture-risk-in-patients-with-osteoporosis
#11
Eugene McCloskey
In the past the management of osteoporosis centred on the use of diagnostic thresholds based on bone mineral density (BMD) measured at the spine or hip by dual x-ray absorptiometry (DXA). Previous guidance was based on an opportunistic case-finding strategy whereby the presence of clinical risk factors would prompt clinicians to measure BMD. Those patients with a BMD value that fell within the range of osteoporosis were considered for treatment. More recently it has been found that the presence of several of these risk factors is associated with a fracture risk greater than can be accounted for by BMD alone...
October 2013: Practitioner
https://www.readbyqxmd.com/read/23892830/new-horizons-in-fracture-risk-assessment
#12
Terry J Aspray
Fracture is the clinical outcome of concern in osteoporosis, a disease variably defined over the last 30 years, mostly in terms of bone mineral density (BMD). However, an 'osseocentric' view of the condition may have hampered our understanding of how best to identify patients at the greatest risk of fragility fracture. More recently, the identification of a number of clinical risk factors for fragility fracture and the creation of fracture risk assessment tools, such as FRAX®, QFracture and Garvan have helped in a move towards clinically useful definitions, using the common currency of 10-year major osteoporotic and 10-year hip fracture risks...
September 2013: Age and Ageing
https://www.readbyqxmd.com/read/23592255/risk-assessment-tools-to-identify-women-with-increased-risk-of-osteoporotic-fracture-complexity-or-simplicity-a-systematic-review
#13
REVIEW
Katrine Hass Rubin, Teresa Friis-Holmberg, Anne Pernille Hermann, Bo Abrahamsen, Kim Brixen
A huge number of risk assessment tools have been developed. Far from all have been validated in external studies, more of them have absence of methodological and transparent evidence, and few are integrated in national guidelines. Therefore, we performed a systematic review to provide an overview of existing valid and reliable risk assessment tools for prediction of osteoporotic fractures. Additionally, we aimed to determine if the performance of each tool was sufficient for practical use, and last, to examine whether the complexity of the tools influenced their discriminative power...
August 2013: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/23482989/assessing-fracture-risk-in-people-with-ms-a-service-development-study-comparing-three-fracture-risk-scoring-systems
#14
Ruth Dobson, Sara Geraldine Leddy, Sunay Gangadharan, Gavin Giovannoni
OBJECTIVES: Suboptimal bone health is increasingly recognised as an important cause of morbidity. Multiple sclerosis (MS) has been consistently associated with an increased risk of osteoporosis and fracture. Various fracture risk screening tools have been developed, two of which are in routine use and a further one is MS-specific. We set out to compare the results obtained by these in the MS clinic population. DESIGN: This was a service development study. The 10-year risk estimates of any fracture and hip fracture generated by each of the algorithms were compared...
2013: BMJ Open
https://www.readbyqxmd.com/read/22826597/qfracture-is-better-than-frax-tool-in-assessing-risk-of-hip-fracture
#15
Antony Johansen
No abstract text is available yet for this article.
2012: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/22688862/fracture-risk-assessment-state-of-the-art-methodologically-unsound-or-poorly-reported
#16
Gary S Collins, Karl Michaëlsson
Osteoporotic fractures, including hip fractures, are a global health concern associated with significant morbidity and mortality as well as a major economic burden. Identifying individuals who are at an increased risk of osteoporotic fracture is an important challenge to be resolved. Recently, multivariable prediction tools have been developed to assist clinicians in the management of their patients by calculating their 10-year risk of fracture (FRAX, QFracture, Garvan) using a combination of known risk factors...
September 2012: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/22619194/derivation-and-validation-of-updated-qfracture-algorithm-to-predict-risk-of-osteoporotic-fracture-in-primary-care-in-the-united-kingdom-prospective-open-cohort-study
#17
Julia Hippisley-Cox, Carol Coupland
OBJECTIVE: To develop and validate an updated version of the QFracture algorithm for estimating the risk of a patient sustaining an osteoporotic fracture or hip fracture in a primary care population. DESIGN: Prospective open cohort study using routinely collected data from 420 general practices in the United Kingdom to develop updated QFracture scores and 207 practices to validate scores. Cox's proportional hazards model was used in the derivation cohort to derive risk equations using several explanatory variables...
May 22, 2012: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/22401729/-estimate-of-the-10-year-risk-of-osteoporotic-fractures-in-the-spanish-population
#18
Beatriz González López-Valcárcel, Manuel Sosa Henríquez
BACKGROUND AND OBJECTIVE: The QFRACTURE(®) tool allows to estimate the risk of osteoporotic fractures in 10 years. We have estimated it, both for major and hip fracture, from the data obtained from the National Health Questionnaire. We thus estimated the risk of fragility fractures in the next 10 years in the Spanish population of both genders and calculated its burden. SUBJECTS AND METHODS: We have used the QFRACTURE(®) tool which estimates the risk of any fracture and hip fracture in the next 10 years...
February 2, 2013: Medicina Clínica
https://www.readbyqxmd.com/read/21647704/clinical-risk-factors-for-osteoporosis-in-ireland-and-the-uk-a-comparison-of-frax-and-qfracturescores
#19
COMPARATIVE STUDY
N M Cummins, E K Poku, M R Towler, O M O'Driscoll, S H Ralston
Recently two algorithms have become available to estimate the 10-year probability of fracture in patients suspected to have osteoporosis on the basis of clinical risk factors: the FRAX algorithm and QFractureScores algorithm (QFracture). The aim of this study was to compare the performance of these algorithms in a study of fracture patients and controls recruited from six centers in the United Kingdom and Ireland. A total of 246 postmenopausal women aged 50-85 years who had recently suffered a low-trauma fracture were enrolled and their characteristics were compared with 338 female controls who had never suffered a fracture...
August 2011: Calcified Tissue International
https://www.readbyqxmd.com/read/19926696/predicting-risk-of-osteoporotic-fracture-in-men-and-women-in-england-and-wales-prospective-derivation-and-validation-of-qfracturescores
#20
MULTICENTER STUDY
Julia Hippisley-Cox, Carol Coupland
OBJECTIVE: To develop and validate two new fracture risk algorithms (QFractureScores) for estimating the individual risk of osteoporotic fracture or hip fracture over 10 years. DESIGN: Prospective open cohort study with routinely collected data from 357 general practices to develop the scores and from 178 practices to validate the scores. SETTING: General practices in England and Wales. PARTICIPANTS: 1 183 663 women and 1 174 232 men aged 30-85 in the derivation cohort, who contributed 7 898 208 and 8 049 306 person years of observation, respectively...
November 19, 2009: BMJ: British Medical Journal
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