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Predicting Fracture Risk

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Bone Densitometry in Clinical Practice

Part of the book series: Current Clinical Practice ((CCP))

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Abstract

The risk of any outcome can be expressed in a variety of different ways, as was noted in Chapter 3. The more commonly used measures of risk are prevalence, incidence, absolute and relative risks, and odds ratios. All of these measures can be employed in the specific context of the assessment of fracture risk. In densitometry, other measures of risk are employed as well, such as the fracture threshold, lifetime risk, and remaining lifetime fracture probability. These are also quantitative measures of risk. Qualitative fracture risk assessments may also be useful. Although there is no question that a measurement of bone density can predict fracture risk, none of the measures used clinically to express fracture risk is ideal. The field as a whole, however, has moved toward the use of absolute risk, projected over varying lengths of time. A physician should ultimately use whichever expression of risk best conveys the implications for fracture, and therefore the need for pharmacologic intervention, based on the patient’s BMD, age, and other risk factors.

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Notes

  1. 1.

    Os calcis and calcaneus are used interchangeably.

  2. 2.

    The minus sign in front of the T-score is disregarded.

  3. 3.

    See Chapter 9 for a discussion of the World Health Organization criteria for the diagnosis of osteoporosis.

  4. 4.

    EPOS is the European Prospective Osteoporosis Study and is a continuation of the European Vertebral Osteoporosis Study (EVOS). EVOS is a study of the prevalence of fracture in men and women conducted at 36 centers in 19 countries in Europe.

  5. 5.

    The Rotterdam Study, the European Vertebral Osteoporosis Study (EVOS), the Canadian Multicentre Osteoporosis Study (CaMOS), Rochester, Sheffield, Dubbo, Hiroshima, and Gothenburg (two cohorts).

  6. 6.

    See Chapter 6for a discussion of conversion equations for BMD from one manufacturers’ device to another.

  7. 7.

    EPIDOS is a multicenter prospective study of 7575 women living at home aged 75–95 years, in France.

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  1. Clinical Research Center of North Texas, 2921, Country Club Road, #101, Denton, TX, USA

    Sydney Lou Bonnick MD, FACP

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Correspondence to Sydney Lou Bonnick MD, FACP .

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© 2010 Humana Press, a part of Springer Science+Business Media, LLC

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Bonnick, S.L. (2010). Predicting Fracture Risk. In: Bone Densitometry in Clinical Practice. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-499-9_10

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  • DOI: https://doi.org/10.1007/978-1-60327-499-9_10

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  • Publisher Name: Humana Press, Totowa, NJ

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