title: Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study.
abstract: To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not.
  
  
  BACKGROUND
  As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose.
  
  
  METHODS
  The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters.
  
  
  RESULTS
  From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s).
  
  
  CONCLUSIONS
  In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not.
authors.affiliation: Department of Internal Medicine, University Hospital, Lausanne, Switzerland. marc-antoine.krieg@chuv.ch
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Krieg
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.forename: Christiane
authors.initials: C
authors.lastname: Ruffieux
authors.forename: Guy
authors.initials: G
authors.lastname: Van Melle
authors.forename: Daniel
authors.initials: D
authors.lastname: Büche
authors.forename: Maximilian A
authors.initials: MA
authors.lastname: Dambacher
authors.forename: Didier
authors.initials: D
authors.lastname: Hans
authors.forename: Florian
authors.initials: F
authors.lastname: Hartl
authors.forename: Hansjorg J
authors.initials: HJ
authors.lastname: Häuselmann
authors.forename: Marius
authors.initials: M
authors.lastname: Kraenzlin
authors.forename: Kurt
authors.initials: K
authors.lastname: Lippuner
authors.forename: Maurus
authors.initials: M
authors.lastname: Neff
authors.forename: Pierro
authors.initials: P
authors.lastname: Pancaldi
authors.forename: Rene
authors.initials: R
authors.lastname: Rizzoli
authors.forename: Franco
authors.initials: F
authors.lastname: Tanzi
authors.forename: Robert
authors.initials: R
authors.lastname: Theiler
authors.forename: Alan
authors.initials: A
authors.lastname: Tyndall
authors.forename: Claus
authors.initials: C
authors.lastname: Wimpfheimer
authors.forename: Peter
authors.initials: P
authors.lastname: Burckhardt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015984:Causality; D005260:Female; D050278:Finger Phalanges / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006365:Heel / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D014463:Ultrasonography / Q000295:instrumentation* / Q000379:methods*