Application of epidemiology to change health policy : defining age-related thresholds of bone mineral density for primary prevention of fracture

Henry, Margaret J., Pasco, Julie A., Sanders, Kerrie M., Kotowicz, Mark A. and Nicholson, Geoffrey C. 2008, Application of epidemiology to change health policy : defining age-related thresholds of bone mineral density for primary prevention of fracture, Journal of clinical densitometry, vol. 11, no. 4, pp. 494-497.

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Title Application of epidemiology to change health policy : defining age-related thresholds of bone mineral density for primary prevention of fracture
Author(s) Henry, Margaret J.
Pasco, Julie A.
Sanders, Kerrie M.
Kotowicz, Mark A.
Nicholson, Geoffrey C.
Journal name Journal of clinical densitometry
Volume number 11
Issue number 4
Start page 494
End page 497
Total pages 6
Publisher Elsevier B.V.
Place of publication Amsterdam, The Netherlands
Publication date 2008-10
ISSN 1094-6950
1559-0747
Keyword(s) Bone mineral density
epidemiology
fracture risk score
health policy
primary prevention of fracture
Summary In Australia, benefits for antifracture therapies have been available for patients with osteoporosis and a prior fracture. No benefits were available to those with no prior fracture. We aimed to define, in women with no prior fracture, age-related thresholds of bone mineral density (BMD) associated with fracture risk equivalent to that of women with prior fracture and osteoporosis. A case-control study of women (≥50 yr) was conducted, including 291 fracture cases and 823 controls. BMD was measured at the proximal femur and posterior anterior (PA) spine. A fracture risk score (FRS) for the group with no prior fracture was calculated with discriminant analysis. The thresholds for equivalent fracture risk between those with no prior fracture and those with prior fracture were assessed using logistic regression. Increasing the FRS to +0.98 in women with no prior fracture resulted in equivalent odds of sustaining a fracture to those with prior fracture and osteoporosis. The corresponding T-score thresholds at the spine were −4.6 at 50 yr, −3.9 at 60 yr, −3.1 at 70 yr, and −2.4 at 80 yr. The femoral neck T-score thresholds were lower by 0.5 standard deviation. The high-risk individuals defined by this study should be considered for primary fracture prevention therapy.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2008, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30042780

Document type: Journal Article
Collections: School of Medicine
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