title: SCOPE: a scorecard for osteoporosis in Europe.
abstract: CONCLUSIONS
  The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe.
  
  
  BACKGROUND
  The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis.
  
  
  METHODS
  The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap).
  
  
  RESULTS
  There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe.
  
  
  CONCLUSIONS
  The scorecard will enable healthcare professionals and policy makers to assess their country's general approach to the disease and provide indicators to inform future provision of healthcare.
authors.affiliation: University of Sheffield Medical School, Sheffield, UK. w.j.pontefract@sheffield.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Kanis
authors.forename: F
authors.initials: F
authors.lastname: Borgström
authors.forename: J
authors.initials: J
authors.lastname: Compston
authors.forename: K
authors.initials: K
authors.lastname: Dreinhöfer
authors.forename: E
authors.initials: E
authors.lastname: Nolte
authors.forename: L
authors.initials: L
authors.lastname: Jonsson
authors.forename: W F
authors.initials: WF
authors.lastname: Lems
authors.forename: E V
authors.initials: EV
authors.lastname: McCloskey
authors.forename: R
authors.initials: R
authors.lastname: Rizzoli
authors.forename: J
authors.initials: J
authors.lastname: Stenmark
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D005102:Health Expenditures; D006291:Health Policy; D006620:Hip Fractures / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D058866:Osteoporotic Fractures / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D011787:Quality of Health Care; D017678:Sex Distribution