Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.
Chotiyarnwong, P; McCloskey, E V; Harvey, Nicket al.
Cost-effectiveness; FRAX; Fracture risk; Screening; Treatment; Female; Humans; Mass Screening/methods; Postmenopause; Quality of Life; Hip Fractures/epidemiology; Hip Fractures/prevention & control; Osteoporosis/diagnosis; Osteoporosis/epidemiology; Hip Fractures; Mass Screening; Osteoporosis; Orthopedics and Sports Medicine
Abstract :
[en] Medical image analysis plays a key role in precision medicine as it allows
the clinicians to identify anatomical abnormalities and it is routinely used in
clinical assessment. Data curation and pre-processing of medical images are
critical steps in the quantitative medical image analysis that can have a
significant impact on the resulting model performance. In this paper, we
introduce a precision-medicine-toolbox that allows researchers to perform data
curation, image pre-processing and handcrafted radiomics extraction (via
Pyradiomics) and feature exploration tasks with Python. With this open-source
solution, we aim to address the data preparation and exploration problem,
bridge the gap between the currently existing packages, and improve the
reproducibility of quantitative medical imaging research.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Chotiyarnwong, P; Department of Oncology & Metabolism, Mellanby Centre for Musculoskeletal Research, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK ; Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
McCloskey, E V; Department of Oncology & Metabolism, Mellanby Centre for Musculoskeletal Research, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK. e.v.mccloskey@sheffield.ac.uk ; Centre for Metabolic Bone Diseases, Northern General Hospital, University of Sheffield, Herries Road, Sheffield, S5 7AU, UK. e.v.mccloskey@sheffield.ac.uk
Harvey, Nick ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Lorentzon, M; University of Gothenburg, Gothenburg, Sweden ; Australian Catholic University, Melbourne, Australia
Prieto-Alhambra, D; Oxford NIHR Biomedical Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK ; GREMPAL (Grup de Recerca en Malalties Prevalents de L'Aparell Locomotor) Research Group, CIBERFes and Idiap Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona and Instituto de Salud Carlos III, Gran Via de Les Corts Catalanes, 591 Atico, 08007, Barcelona, Spain
Abrahamsen, B; Department of Clinical Research, Odense Patient Data Exploratory Network, University of Southern Denmark, Odense, Denmark ; Department of Medicine, Holbæk Hospital, Holbæk, Denmark
Adachi, J D; Department of Medicine, Michael G DeGroote School of Medicine, St Joseph's Healthcare-McMaster University, Hamilton, ON, Canada
Borgström, F; Quantify Research, Stockholm, Sweden ; Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
Bruyère, Olivier ; Université de Liège - ULiège > Unité de recherche Santé publique, épidémiologie et économie de la santé (URSAPES)
Carey, J J; School of Medicine, National University of Ireland Galway, Galway, Ireland ; Department of Rheumatology, Galway University Hospitals, Galway, Ireland
Clark, P; Clinical Epidemiology Unit of Hospital Infantil de México Federico Gómez-Faculty of Medicine, Universidad Nacional Autónoma de México, UNAM, Mexico City, Mexico
Cooper, Cyrus ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Curtis, E M; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Dennison, E; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Diaz-Curiel, M; Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
Dimai, H P; Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
Grigorie, D; Carol Davila University of Medicine, Bucharest, Romania ; Department of Endocrinology & Bone Metabolism, National Institute of Endocrinology, Bucharest, Romania
Hiligsmann, Mickaël ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
Khashayar, P; Center for Microsystems Technology, Imec and Ghent University, 9050, Ghent, Belgium
Lewiecki, E M; New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
Lips, P; Department of Internal Medicine, Endocrine Section & Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
Lorenc, R S; Multidisciplinary Osteoporosis Forum, SOMED, Warsaw, Poland
Ortolani, S; IRCCS Istituto Auxologico, UO Endocrinologia E Malattie del Metabolismo, Milano, Italy
Papaioannou, A; Department of Medicine, McMaster University, Hamilton, ON, Canada ; GERAS Centre for Aging Research, Hamilton, ON, Canada
Silverman, S; Cedars-Sinai Medical Center, Los Angeles, CA, USA
Sosa, M; Bone Metabolic Unit, University of Las Palmas de Gran Canaria, Hospital University Insular, Las Palmas, Gran Canaria, Spain
Szulc, P; INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
Ward, K A; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Yoshimura, N; Department of Preventive Medicine for Locomotive Organ Disorders, 22Nd Century Medical and Research Center, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
Kanis, J A; Centre for Metabolic Bone Diseases, Northern General Hospital, University of Sheffield, Herries Road, Sheffield, S5 7AU, UK ; Australian Catholic University, Melbourne, Australia
Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.
Publication date :
2022
Journal title :
Archives of Osteoporosis
ISSN :
1862-3522
eISSN :
1862-3514
Publisher :
Springer Science and Business Media Deutschland GmbH, England
E.V.M reports consultant/advisor fees, speaker honoraria and or, research funding from AgNovos, Amgen, Consilient Healthcare, Fresenius Kabi, Gedeon Richter, Internis, Lilly, Novartis, ObsEva, Synexus and UCB, all outside the submitted work. E.M.C. reports lecture fees and travel support from Eli Lilly, Pfizer and UCB, outside the submitted work. N.C.H. reports personal fees, consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, UCB, Kyowa Kirin, Servier, Shire, Consilient Healthcare and Internis Pharma, outside the submitted work. J.A.K. reports a grant from UCB, outside the submitted work. He is the architect of FRAX® but has no financial interest. C.C. reports personal fees from ABBH, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier and Takeda, outside the submitted work. B.A. reports grants and personal fees from UCB, personal fees from Amgen, grants from Novartis, grants and personal fees from Pharma-cosmos, grants and personal fees from Kyowa Kirin, personal fees for Gedeon Richter outside the submitted work. BA also serves on the NovoNordisk Foundation Grants Committee on Endocrinology and Metabolism. M.L. reports lecture fees from Amgen, Astellas, Lilly, Meda, Renapharma and UCB Pharma and consulting fees from Amgen, Radius Health, UCB Pharma, Renapharma and Consilient Health, outside the submitted work. D.P-A. reports institutional receipt of speaker fees from AMGEN and UCB Biopharma; consultancy fees from UCB Biopharma; research grants from UCB, Amgen, and Les Laboratoires Servier, all outside of the submitted work. J. A. reports grants and personal fees from Amgen outside the submitted work, grants from Radius and has been an advisor to Gilead and is part of their speaker’s bureau, outside the submitted work. F.B. is employed and is a shareholder in Quantify Research, a health economic research consultancy, outside of the submitted work. O.B. reports grant support from IBSA, MSD, Nutraveris, Novartis, Pfizer, Rottapharm, Servier and Theramex; consulting or lecture fees from Bayer, Genevrier, IBSA, Rottapharm, Servier, SMB and TRB Chemedica; all outside the submitted work. All other authors have no relevant conflicts of interest in relation to the submitted work.This position paper was prepared by the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group and has been endorsed by the International Osteoporosis Foundation. We are grateful for administrative support from Dr Dominique Pierroz.Work informing this project was supported by the UK Medical Research Foundation (MRF-145–0011-DG-HARV-C0913). N.C.H., E.M.C., E.M.D. and C.C. are supported by the UK Medical Research Council (MC_PC_21003; MC_PC_21001).
Wilson JMG, Jungner G (1968) Principles and practice of screening for disease. World Health Organization https://apps.who.int/iris/handle/10665/37650. Accessed 18 Aug 2021
Shepstone L, Fordham R, Lenaghan E et al (2012) A pragmatic randomised controlled trial of the effectiveness and cost-effectiveness of screening older women for the prevention of fractures: rationale, design and methods for the SCOOP study. Osteoporos Int 23:2507–2515
Shepstone L, Lenaghan E, Cooper C et al (2018) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet 391:741–747
McCloskey E, Johansson H, Harvey NC et al (2018) Management of patients with high baseline hip fracture risk by FRAX reduces hip fractures-a post hoc analysis of the SCOOP study. J Bone Miner Res 33:1020–1026
Parsons CM, Harvey N, Shepstone L et al (2019) Systematic screening using FRAX((R)) leads to increased use of, and adherence to, anti-osteoporosis medications: an analysis of the UK SCOOP trial. Osteoporos Int 31:67–75
Turner DA, Khioe RFS, Shepstone L et al (2018) The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. J Bone Miner Res 33:845–851
Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256
Anon (1993) Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650
Leslie WD, Morin S (2011) Fracture burden in relation to low bone mineral density and FRAX((R)) probability. J Clin Densitom 14:279–285
Svedbom A, Ivergard M, Hernlund E, Rizzoli R, Kanis JA (2014) Epidemiology and economic burden of osteoporosis in Switzerland. Arch Osteoporos 9:187
Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, McCloskey EV, Willers C, Borgstrom F (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos 16:82
Borgstrom F, Karlsson L, Ortsater G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59
Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733
Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA, Epidemiology ICWGoF (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288
Lorentzon M, Johansson H, Harvey NC, Liu E, Vandenput L, McCloskey EV, Kanis JA (2022) Osteoporosis and fractures in women: the burden of disease. Climacteric 25:4–10
Svedbom A, Hernlund E, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137
Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136
Oden A, McCloskey EV, Kanis JA, Harvey NC, Johansson H (2015) Burden of high fracture probability worldwide: secular increases 2010–2040. Osteoporos Int 26:2243–2248
Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C, Epidemiology IOFWGo, Quality of L, (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256
Berry SD, Miller RR (2008) Falls: epidemiology, pathophysiology, and relationship to fracture. Curr Osteoporos Rep 6:149–154
Gibson M (1987) The prevention of falls in later life. Dan Med Bull 34(Suppl 4):1–24
Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427
Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248–1250
Poor G, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1995) Determinants of reduced survival following hip fractures in men. Clin Orthop 319:260–265
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473
Johnell O, Kanis JA, Oden A et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194
WHO (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. World Health Organization, Geneva
Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141
Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475
US Preventive Services Task Force (2011) Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med 154:356–364
US Preventive Services Task Force (2018) Screening for osteoporosis to prevent fractures US preventive services task force recommendation statement. JAMA 319(24):2521–2531. 10.1001/jama20187498 DOI: 10.1001/jama20187498
Collins GS, Altman DG (2010) An independent and external validation of QRISK2 cardiovascular disease risk score: a prospective open cohort study. BMJ 340:c2442
D’Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB (2008) General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 117:743–753
Goff DC Jr, Lloyd-Jones DM, Bennett G et al (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:2935–2959
De Laet C, Kanis JA, Oden A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338
Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382
Kanis JA, Johansson H, Oden A et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037
Kanis JA, Johansson H, Oden A et al (2004) A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 19:893–899
Xue AL, Wu SY, Jiang L, Feng AM, Guo HF, Zhao P (2017) Bone fracture risk in patients with rheumatoid arthritis: a meta-analysis. Medicine (Baltimore) 96:e6983
Vilaca T, Walsh J, Eastell R (2019) Discordant pattern of peripheral fractures in diabetes: a meta-analysis on the risk of wrist and ankle fractures. Osteoporos Int 30:135–143
Janghorbani M, Van Dam RM, Willett WC, Hu FB (2007) Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol 166:495–505
Leslie WD, Rubin MR, Schwartz AV, Kanis JA (2012) Type 2 diabetes and bone. J Bone Miner Res 27:2231–2237
Kanis JA on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK, University of Sheffield
Feskanich D, Willett W, Colditz G (2002) Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 288:2300–2306
Leslie WD, Morin SN, Lix LM, Martineau P, Bryanton M, McCloskey EV, Johansson H, Harvey NC, Kanis JA (2019) Fracture prediction from self-reported falls in routine clinical practice: a registry-based cohort study. Osteoporos Int 30:2195–2203
Morrison A, Fan T, Sen SS, Weisenfluh L (2013) Epidemiology of falls and osteoporotic fractures: a systematic review. Clinicoecon Outcomes Res 5:9–18
Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162
Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA, Pols H, Tenenhouse A (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742
Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D (2019) Pharmacological management of osteoporosis in postmenopausal women: an endocrine society* Clinical Practice Guideline. J Clin Endocrinol Metab 104:1595–1622
Compston J, Cooper A, Cooper C et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43
Kanis JA, Cooper C, Rizzoli R, Reginster JY, Scientific Advisory Board of the European Society for C, Economic Aspects of O, the Committees of Scientific A, National Societies of the International Osteoporosis F (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44
Papaioannou A, Morin S, Cheung AM et al (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–1873
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R (2014) Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 25:2359–2381
Harvey NC, Biver E, Kaufman JM et al (2017) The role of calcium supplementation in healthy musculoskeletal ageing: an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF). Osteoporos Int 28:447–462
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine S (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930
Scientific Advisory Committee on Nutrition (2016) Vitamin D and health https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition. Accessed 18 Aug 2021
Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon R (2019) Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol 180:P23–P54
Society NO (2013) Vitamin D and bone health: a practical clinical guideline for patient management. https://www.nos.org.uk/document.doc?id=1352. Accessed 18 Aug 2021
Weaver CM, Alexander DD, Boushey CJ, Dawson-Hughes B, Lappe JM, LeBoff MS, Liu S, Looker AC, Wallace TC, Wang DD (2016) Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 27:367–376
Weaver CM, Dawson-Hughes B, Lappe JM, Wallace TC (2016) Erratum and additional analyses re: Calcium plus vitamin D supplementation and the risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 27:2643–2646
Zhao JG, Zeng XT, Wang J, Liu L (2017) Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. JAMA 318:2466–2482
Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397
Kanis J.A. on behalf of the WHO Scientific Group (2008) Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre, University of Sheffield, UK, Sheffield
Hippisley-Cox J, Coupland C (2012) Derivation and validation of updated QFracture algorithm to predict risk of osteoporotic fracture in primary care in the United Kingdom: prospective open cohort study. BMJ 344:e3427
Hippisley-Cox J, Coupland C (2009) Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ 339:b4229
Nguyen ND, Eisman JA, Center JR, Nguyen TV (2007) Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab 92:955–962
Kanis JA, Harvey NC, Cooper C, Johansson H, Oden A, McCloskey EV, Advisory Board of the National Osteoporosis Guideline G (2016) A systematic review of intervention thresholds based on FRAX: a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11:25
Johansson H, Kanis JA, Oden A, Compston J, McCloskey E (2012) A comparison of case-finding strategies in the UK for the management of hip fractures. Osteoporos Int 23:907–915
McCloskey E, Kanis JA, Johansson H et al (2015) FRAX-based assessment and intervention thresholds–an exploration of thresholds in women aged 50 years and older in the UK. Osteoporos Int 26:2091–2099
Kanis JA, Johansson H, Harvey NC, McCloskey EV (2018) A brief history of FRAX. Arch Osteoporos 13:118
Kanis JA, Harvey NC, Johansson H, Liu E, Vandenput L, Lorentzon M, Leslie WD, McCloskey EV (2020) A decade of FRAX: how has it changed the management of osteoporosis? Aging Clin Exp Res 32:187–196
Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238
Clynes MA, Westbury LD, Dennison EM et al (2020) Bone densitometry worldwide: a global survey by the ISCD and IOF. Osteoporos Int 31:1779–1786
Curtis EM, Woolford S, Holmes C, Cooper C, Harvey NC (2020) General and specific considerations as to why osteoporosis-related care is often suboptimal. Curr Osteoporos Rep 18:38–46
Harvey NC, McCloskey EV, Mitchell PJ, Dawson-Hughes B, Pierroz DD, Reginster JY, Rizzoli R, Cooper C, Kanis JA (2017) Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. Osteoporos Int 28:1507–1529
National Institute for Health and Care Excellence (2012) NICE Clinical Guideline 146. Osteoporosis: assessing the risk of fragility fracture. https://www.nice.org.uk/guidance/cg146. Accessed 19 May 2022
Kanis JA, Oden A, Johnell O et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046
Chlebowski RT, Anderson GL, Lane DS, Aragaki AK, Rohan T, Yasmeen S, Sarto G, Rosenberg CA, Hubbell FA, Women’s Health Initiative I (2007) Predicting risk of breast cancer in postmenopausal women by hormone receptor status. J Natl Cancer Inst 99:1695–1705
Viswanathan M, Reddy S, Berkman N, Cullen K, Middleton JC, Nicholson WK, Kahwati LC (2018) Screening to prevent osteoporotic fractures: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 319:2532–2551
Leslie WD, Lix LM (2014) Comparison between various fracture risk assessment tools. Osteoporos Int 25:1–21
Marques A, Ferreira RJ, Santos E, Loza E, Carmona L, da Silva JA (2015) The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis 74:1958–1967
Nayak S, Edwards DL, Saleh AA, Greenspan SL (2015) Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density. Osteoporos Int 26:1543–1554
Kanis JA, Oden A, Johansson H, McCloskey E (2012) Pitfalls in the external validation of FRAX. Osteoporos Int 23:423–431
Dagan N, Cohen-Stavi C, Leventer-Roberts M, Balicer RD (2017) External validation and comparison of three prediction tools for risk of osteoporotic fractures using data from population based electronic health records: retrospective cohort study. BMJ 356:i6755
Baleanu F, Iconaru L, Charles A, et al. (2021) Independent external validation of FRAX and Garvan fracture risk calculators: a sub-study of the FRISBEE cohort. Journal of Bone and Mineral Research (eprint ahead of publication) 101002/jbm410532
National Institute for Clinical Excellence (2017) Bisphosphonates for treating osteoporosis. https://www.niceorguk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-pdf-82604905556677. Accessed 18 Aug 2021
Harvey NC, McCloskey E, Kanis JA, Compston J, Cooper C (2017) Bisphosphonates in osteoporosis: NICE and easy? Lancet 390:2243–2244
NICE. (2017) Osteoporosis. NICE Quality Standard 149. NICE, 2017. Available at: www.nice.org.uk/qs149. Accessed 18 Aug 2021
Compston J, Bowring C, Cooper A et al (2013) Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas 75:392–396
Compston J, Cooper A, Cooper C, Francis R, Kanis JA, Marsh D, McCloskey EV, Reid DM, Selby P, Wilkins M (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–108
Lekamwasam S, Adachi JD, Agnusdei D et al (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23:2257–2276
Clark P, Denova-Gutierrez E, Zerbini C et al (2018) FRAX-based intervention and assessment thresholds in seven Latin American countries. Osteoporos Int 29:707–715
Lesnyak O, Zakroyeva A, Babalyan V et al (2021) FRAX-based intervention thresholds in eight Eurasian countries: Armenia, Belarus, Georgia, Kazakhstan, the Kyrgyz Republic, Moldova, the Russian Federation, and Uzbekistan. Arch Osteoporos 16:87
Kanis JA, Stevenson M, McCloskey EV, Davis S, Lloyd-Jones M (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 11:1–256
Sekhon M, Cartwright M, Francis JJ (2017) Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 17:88
Damilakis J, Adams JE, Guglielmi G, Link TM (2010) Radiation exposure in X-ray-based imaging techniques used in osteoporosis. Eur Radiol 20:2707–2714
McCloskey EV, Johansson H, Harvey NC, Compston J, Kanis JA (2017) Access to fracture risk assessment by FRAX and linked National Osteoporosis Guideline Group (NOGG) guidance in the UK-an analysis of anonymous website activity. Osteoporos Int 28:71–76
Chotiyarnwong P, Harvey NC, Johansson H, Liu E, Lorentzen M, Kanis JA, McCloskey EV (2019) Temporal changes in access to FRAX(R) in Thailand between 2010 and 2018. Arch Osteoporos 14:66
Emmett CL, Redmond NM, Peters TJ, Clarke S, Shepstone L, Lenaghan E, Shaw AR (2012) Acceptability of screening to prevent osteoporotic fractures: a qualitative study with older women. Fam Pract 29:235–242
Kanis JA, Borgstrom F, Compston J, Dreinhofer K, Nolte E, Jonsson L, Lems WF, McCloskey EV, Rizzoli R, Stenmark J (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8:144
Coronado-Zarco R, Olascoaga-Gomez de Leon A, Garcia-Lara A, Quinzanos-Fresnedo J, Nava-Bringas TI, Macias-Hernandez SI (2019) Nonpharmacological interventions for osteoporosis treatment: systematic review of clinical practice guidelines. Osteoporos Sarcopenia 5:69–77
Rizzoli R (2022) Dairy products and bone health. Aging Clin Exp Res 34:9–24
Cummings SR, Nevitt MC (1989) A hypothesis: the causes of hip fractures. J Gerontol 44:M107-111
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE (2012) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012(9):CD007146. 10.1002/14651858.CD007146.pub3
Bhasin S, Gill TM, Reuben DB et al (2020) A randomized trial of a multifactorial strategy to prevent serious fall injuries. N Engl J Med 383:129–140
Lamb SE, Bruce J, Hossain A et al (2020) Screening and intervention to prevent falls and fractures in older people. N Engl J Med 383:1848–1859
Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL (2018) Interventions to prevent falls in older adults: updated evidence report and systematic review for the US preventive services task force. JAMA 319:1705–1716
Crandall CJ, Newberry SJ, Diamant A, Lim YW, Gellad WF, Booth MJ, Motala A, Shekelle PG (2014) Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review. Ann Intern Med 161:711–723
Black DM, Cummings SR, Karpf DB et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group Lancet 348:1535–1541
McClung MR, Geusens P, Miller PD et al (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340
Black DM, Delmas PD, Eastell R et al (2007) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809–1822
Kendler DL, Marin F, Zerbini CAF et al (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 391:230–240
Saag KG, Petersen J, Brandi ML, Karaplis AC, Lorentzon M, Thomas T, Maddox J, Fan M, Meisner PD, Grauer A (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377:1417–1427
McClung MR (2021) Role of bone-forming agents in the management of osteoporosis. Aging Clin Exp Res 33:775–791
Cosman F, Nieves JW, Dempster DW (2017) Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res 32:198–202
Kanis JA, Cooper C, Rizzoli R et al (2017) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int 28:2023–2034
Kanis JA, Harvey NC, McCloskey E et al (2020) Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int 31:1–12
Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001) Cost-effectiveness of preventing hip fracture in the general female population. Osteoporos Int 12:356–361
Rossouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333
Anderson GL, Limacher M, Assaf AR et al (2004) Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA 291:1701–1712
Cauley JA, Robbins J, Chen Z et al (2003) Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women’s Health Initiative randomized trial. JAMA 290:1729–1738
McCloskey EV, Beneton M, Charlesworth D et al (2007) Clodronate reduces the incidence of fractures in community-dwelling elderly women unselected for osteoporosis: results of a double-blind, placebo-controlled randomized study. J Bone Miner Res 22:135–141
McCloskey EV, Johansson H, Oden A, Vasireddy S, Kayan K, Pande K, Jalava T, Kanis JA (2009) Ten-year fracture probability identifies women who will benefit from clodronate therapy–additional results from a double-blind, placebo-controlled randomised study. Osteoporos Int 20:811–817
McCloskey E (2016) A BMD threshold for treatment efficacy in osteoporosis? A need to consider the whole evidence base. Osteoporos Int 27:417–419
National Institute for Clinical Excellence NICE (2005) Technology appraisal guidance 87. Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. National Institute for Clinical Excellence, London
NICE (2008) TA161 (revised) Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. National Institute for Health and Clinical Excellence. https://www.nice.org.uk/guidance/ta161. Accessed 14 August 2021
NICE (2008) TA160. Raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women. https://www.nice.org.uk/guidance/ta160. Accessed 19 May 2022
NICE (2008) TA161 Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. https://www.nice.org.uk/guidance/ta161. Accessed 14 August 2021
NICE (2010) Denosumab for the prevention of osteoporotic fractures in postmenopausal women. https://www.nice.org.uk/guidance/ta204. Accessed 19 May 2022
National Institute for Health and Care Excellence (2017) Bisphosphonates for treating osteoporosis. https://www.nice.org.uk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-pdf-82604905556677. Updated: Jul 8, 2019. Accessed 18 Aug 2021
British Orthopaedic Association (2007) The care of patients with fragility fracture. Available at: http://www.boaacuk/Publications/Documents/The%20Care%20of%20Patients%20with%20Fragility%20Fracturepdf. Accessed 18 Aug 2021
NICE (2011) Hip fracture: management. Clinical guideline CG124. Published: 22 June 2011 (Updated May 2017) www.nice.org.uk/guidance/cg124. Accessed 18 Aug 2021
Neuburger J, Currie C, Wakeman R, Tsang C, Plant F, De Stavola B, Cromwell DA, van der Meulen J (2015) The impact of a national clinician-led audit initiative on care and mortality after hip fracture in England: an external evaluation using time trends in non-audit data. Med Care 53:686–691
Chesser TJS, Inman D, Johansen A et al (2020) Hip fracture systems-European experience. OTA Int 3:e050
Marsh D, Akesson K, Beaton DE et al (2011) Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int 22:2051–2065
Akesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD, Kyer C, Cooper C, Group IOFFW (2013) Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24:2135–2152
Majumdar SR, McAlister FA, Johnson JA et al (2018) Comparing strategies targeting osteoporosis to prevent fractures after an upper extremity fracture (C-STOP Trial): a randomized controlled trial. J Bone Miner Res 33:2114–2121
Majumdar SR, Johnson JA, McAlister FA, Bellerose D, Russell AS, Hanley DA, Morrish DW, Maksymowych WP, Rowe BH (2008) Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ 178:569–575
Majumdar SR, Rowe BH, Folk D et al (2004) A controlled trial to increase detection and treatment of osteoporosis in older patients with a wrist fracture. Ann Intern Med 141:366–373
Javaid MK (2021) Efficacy and efficiency of fracture liaison services to reduce the risk of recurrent osteoporotic fractures. Aging Clin Exp Res 33:2061–2067
Axelsson KF, Johansson H, Lundh D, Moller M, Lorentzon M (2020) Association between recurrent fracture risk and implementation of fracture liaison services in four swedish hospitals: a cohort study. J Bone Miner Res 35:1216–1223
McCloskey E, Rathi J, Heijmans S et al (2021) The osteoporosis treatment gap in patients at risk of fracture in European primary care: a multi-country cross-sectional observational study. Osteoporos Int 32:251–259
Leroy S, Saunders-Hastings P, Eusebi P, Taieb V, Abrahamsen B, McCloskey EV, Fujiwara S, Libanati C, Moayyeri A (2022) Treatment gap among patients with primary osteoporosis: a systematic literature review and meta-analysis. Osteoporosis International 32 (Suppl 1) (10.1007/s00198-021-06125-9):S189
Bussell ME (2021) Improving bone health: addressing the burden through an integrated approach. Aging Clin Exp Res 33:2777–2786
Rubin KH, Rothmann MJ, Holmberg T et al (2018) Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study. Osteoporos Int 29:567–578
Merlijn T, Swart KM, van Schoor NM et al (2019) The effect of a screening and treatment program for the prevention of fractures in older women: a randomized pragmatic trial. J Bone Miner Res 34:1993–2000
Rubin KH, Holmberg T, Rothmann MJ et al (2015) The risk-stratified osteoporosis strategy evaluation study (ROSE): a randomized prospective population-based study. Design and baseline characteristics. Calcif Tissue Int 96:167–179
Merlijn T, Swart KMA, Netelenbos JC, Elders PJM (2020) Reply to “Screening for high fracture risk.” Osteoporos Int 31:1183–1184
Merlijn T, Swart KMA, van der Horst HE, Netelenbos JC, Elders PJM (2020) Fracture prevention by screening for high fracture risk: a systematic review and meta-analysis. Osteoporos Int 31:251–257
McCloskey EV, Lenaghan E, Clarke S, et al. (2016) Screening based on FRAX fracture risk assessment reduces the incidence of hip fractures in older community-dwelling women – results from the SCOOP study in the UK Journal of Bone and Mineral Research 31(S1):S40. https://www.asbmronlinelibrarywileycom/doi/epdf/101002/jbmr3107. Accessed 18 Aug 2021
McCloskey EV, Harvey NC, Johansson H, Lorentzon M, Vandenput L, Liu E, Kanis JA (2021) Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures. Osteoporos Int 32:39–46
Njeh CF, Fuerst T, Hans D, Blake GM, Genant HK (1999) Radiation exposure in bone mineral density assessment. Appl Radiat Isot 50:215–236
Torgerson DJ, Thomas RE, Campbell MK, Reid DM (1997) Randomized trial of osteoporosis screening. Use of hormone replacement therapy and quality-of-life results. Arch Intern Med 157:2121–2125
Reventlow SD, Hvas L, Malterud K (2006) Making the invisible body visible. Bone scans, osteoporosis and women’s bodily experiences. Soc Sci Med 62:2720–2731
Richardson JC, Hassell AB, Hay EM, Thomas E (2002) “I’d rather go and know”: women’s understanding and experience of DEXA scanning for osteoporosis. Health Expect 5:114–126
Black DM, Geiger EJ, Eastell R, Vittinghoff E, Li BH, Ryan DS, Dell RM, Adams AL (2020) Atypical femur fracture risk versus fragility fracture prevention with bisphosphonates. N Engl J Med 383:743–753
Shane E, Burr D, Abrahamsen B et al (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29:1–23
Khosla S, Burr D, Cauley J et al (2007) Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 22:1479–1491
van de Laarschot DM, McKenna MJ, Abrahamsen B, Langdahl B, Cohen-Solal M, Guanabens N, Eastell R, Ralston SH, Zillikens MC (2020) Medical management of patients after atypical femur fractures: a systematic review and recommendations from the European Calcified Tissue Society. J Clin Endocrinol Metab 105:682–1689
Abrahamsen B, Eiken P, Prieto-Alhambra D, Eastell R (2016) Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate: nationwide cohort and nested case-control study. BMJ 353:i3365
Barr RJ, Stewart A, Torgerson DJ, Reid DM (2010) Population screening for osteoporosis risk: a randomised control trial of medication use and fracture risk. Osteoporos Int 21:561–568
Soreskog E, Borgstrom F, Shepstone L et al (2020) Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study. Osteoporos Int 31:1499–1506
Owen L, Pennington B, Fischer A, Jeong K (2017) The cost-effectiveness of public health interventions examined by NICE from 2011 to 2016. Journal of Public Health | Vol 40, No 3, pp 557–566 | 101093/pubmed/fdx119 40:557–566 (510.1093/pubmed/fdx1119)
Pharoah PD, Sewell B, Fitzsimmons D, Bennett HS, Pashayan N (2013) Cost effectiveness of the NHS breast screening programme: life table model. BMJ 346:f2618
Lee D, Muston D, Sweet A, Cunningham C, Slater A, Lock K (2010) Cost effectiveness of CT colonography for UK NHS colorectal cancer screening of asymptomatic adults aged 60–69 years. Appl Health Econ Health Policy 8(13):141–154
Department of Health (2009) Falls and fractures: effective interventions in health and social care. https://www.laterlifetraining.co.uk/wp-content/uploads/2011/12/FF_Effective-Interventions-in-health-and-social-care.pdf. Accessed 19 May 2022
Condurache CI, Chiu S, Chotiyarnwong P et al (2020) Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study. Osteoporos Int 31:457–464
Solutions for Public Health (2019) Screening for osteoporosis in postmenopausal women. External review against programme appraisal criteria for the UK National Screening Committee. https://view-health-screening-recommendations.service.gov.uk/osteoporosis/. Accessed 18 Aug 2021
UK National Screening Committee (2019) Screening for Osteoporosis in Postmenopausal Women 08 November 2019. https://view-health-screening-recommendations.service.gov.uk/osteoporosis/. Accessed 18 Aug 2021
EUnetHTA OTCA19 Assessment Team. (2019) Screening for osteoporosis in the general population. Collaborative Assessment. Diemen (The Netherlands): EUnetHTA; 2019. Report No.: OTCA19. Available from https://www.eunethta.eu. Accessed 18 Aug 2021
Gail MH, Pfeiffer RM (2018) Breast cancer risk model requirements for counseling, prevention, and screening. J Natl Cancer Inst 110:994–1002
Clark EM, Gould V, Morrison L, Ades AE, Dieppe P, Tobias JH (2012) Randomized controlled trial of a primary care-based screening program to identify older women with prevalent osteoporotic vertebral fractures: Cohort for Skeletal Health in Bristol and Avon (COSHIBA). J Bone Miner Res 27:664–671
