title: An assessment tool for predicting fracture risk in postmenopausal women.
abstract: Due to the magnitude of the morbidity and mortality associated with untreated osteoporosis, it is essential that high-risk individuals be identified so that they can receive appropriate evaluation and treatment. The objective of this investigation was to develop a simple clinical assessment tool based on a small number of risk factors that could be used by women or their clinicians to assess their risk of fractures. Using data from the Study of Osteoporotic Fractures (SOF), a total of 7782 women age 65 years and older with bone mineral density (BMD) measurements and baseline risk factors were included in the analysis. A model with and without BMD T-scores was developed by identifying variables that could be easily assessed in either clinical practice or by self-administration. The assessment tool, called the FRACTURE Index, is comprised of a set of seven variables that include age; BMD T-score, fracture after age 50 years, maternal hip fracture after age 50, weight less than or equal to 125 pounds (57 kg), smoking status, and use of arms to stand up from a chair. The FRACTURE Index was shown to be predictive of hip fracture, as well as vertebral and nonvertebral fractures. In addition, this index was validated using the EPIDOS fracture study. The FRACTURE Index can be used either with or without BMD testing by older postmenopausal women or their clinicians to assess the 5-year risk of hip and other osteoporotic fractures, and could be useful in helping to determine the need for further evaluation and treatment of these women.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco 94105, USA. DBlack@psg.ucsf.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Black
authors.forename: M
authors.initials: M
authors.lastname: Steinbuch
authors.forename: L
authors.initials: L
authors.lastname: Palermo
authors.forename: P
authors.initials: P
authors.lastname: Dargent-Molina
authors.forename: R
authors.initials: R
authors.lastname: Lindsay
authors.forename: M S
authors.initials: MS
authors.lastname: Hoseyni
authors.forename: O
authors.initials: O
authors.lastname: Johnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D009068:Movement; D016017:Odds Ratio; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity