Journal ArticleDOI
Assessment of fracture risk.
John A. Kanis,F. Borgström,Chris De Laet,Helena Johansson,Olof Johnell,Bengt Jönsson,Anders Odén,Niklas Zethraeus,Bruce Pfleger,Nikolai Khaltaev +9 more
TLDR
The diagnosis of osteoporosis is based on the measurement of bone mineral density, but there are a number of clinical risk factors that provide information on fracture risk over and above that given by BMD.Abstract:
The diagnosis of osteoporosis is based on the measurement of bone mineral density (BMD). There are a number of clinical risk factors that provide information on fracture risk over and above that given by BMD. The assessment of fracture risk thus needs to be distinguished from diagnosis to take account of the independent value of the clinical risk factors. These include age, a prior fragility fracture, a parental history of hip fracture, smoking, use of systemic corticosteroids, excess alcohol intake and rheumatoid arthritis. The independent contribution of these risk factors can be integrated by the calculation of fracture probability with or without the use of BMD. Treatment can then be offered to those identified to have a fracture probability greater than an intervention threshold.read more
Citations
More filters
Journal ArticleDOI
European guidance for the diagnosis and management of osteoporosis in postmenopausal women
John A. Kanis,Eugene V. McCloskey,Helena Johansson,Cyrus Cooper,René Rizzoli,Jean-Yves Reginster +5 more
TL;DR: In this paper, the European Foundation for Osteoporosis and Bone disease (subsequently the International osteopo- rosis Foundation) published guidelines for the diagnosis and management of osteoporrosis in a European setting.
Journal Article
KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)
Journal ArticleDOI
The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women.
John A. Kanis,Anders Odén,Olof Johnell,Helena Johansson,C De Laet,Jacques P. Brown,Peter Burckhardt,Cyrus Cooper,Claus Christiansen,Steven R. Cummings,John A. Eisman,S. Fujiwara,C.-C. Glüer,David Goltzman,Didier Hans,M-A Krieg,A.Z. La Croix,Eugene V. McCloskey,Dan Mellström,Lee J. Melton,Huib A.P. Pols,Jonathan Reeve,Kerrie M. Sanders,A. M. Schott,Alan J. Silman,David J. Torgerson,T. P. van Staa,Nelson B. Watts,Noriko Yoshimura +28 more
TL;DR: BMD and clinical risk factors predict hip and other osteoporotic fractures with higher specificity and sensitivity than either alone and provide the basis for the integrated use of validated Clinical risk factors in men and women to aid in fracture risk prediction.
Journal ArticleDOI
A reference standard for the description of osteoporosis.
John A. Kanis,Eugene V. McCloskey,Helena Johansson,Anders Odén,L. Joseph Melton,Nikolai Khaltaev +5 more
TL;DR: This paper proposes that the reference standard should be based on bone mineral density (BMD) measurement made at the femoral neck with dual-energy X-ray absorptiometry (DXA), which has been the most extensively validated, and provides a gradient of fracture risk as high as or higher than that of many other techniques.
Journal ArticleDOI
Osteoporosis: trends in epidemiology, pathogenesis and treatment
P. N. Sambrook,Cyrus Cooper +1 more
TL;DR: Clinical assessment will probably evolve from decisions mainly being made on the basis of bone densitometry, to use of algorithms of absolute fracture risk, and other diagnostic and therapeutic approaches, including biological agents, are likely to become more widespread.
References
More filters
Journal ArticleDOI
Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group.
Steven R. Cummings,Michael C. Nevitt,Warren S. Browner,Katie L. Stone,Kathleen M. Fox,Kristine E. Ensrud,Jane A. Cauley,Dennis Black,Thomas M. Vogt +8 more
TL;DR: Women with multiple risk factors and low bone density have an especially high risk of hip fracture and maintaining body weight, walking for exercise, avoiding long-acting benzodiazepines, minimizing caffeine intake, and treating impaired visual function are among the steps that may decrease the risk.
Journal ArticleDOI
Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures
TL;DR: Measurements of bone mineral density can predict fracture risk but cannot identify individuals who will have a fracture, and a programme of screening menopausal women for osteoporosis by measuring bone density cannot be recommended.
Journal ArticleDOI
The diagnosis of osteoporosis
TL;DR: This paper summarizes issues and proposes diagnostic criteria for osteoporosis for practical use and addresses a number of problems which need to be addressed in adapting a conceptual definition for clinical use.
Assessment of fracture risk and its application to screening for postmenopausal osteoporos
L. Alexeeva,P. Burkhardt,C. Christiansen,C. Cooper,P. Delmas,O. Johnell,C. Johnston,J. Kanis,P. Lips,Lee J. Melton,P. Meunier,Ego Seeman,J. Stepan,A. Tosteson,N. Khaltaev,J. P. Bonjour,H. Gong-Yi,R. Lindsay +17 more
TL;DR: There is little evidence that osteoporosis can usefully be tackled by a public health policy to influence risk factors such as smoking, exercise and nutrition, so the selective use of screening techniques will improve the cost-benefit ratio of intervention.