Predictive performance of the Garvan Fracture Risk Calculator: a registry-based cohort study.
- Publisher:
- SPRINGER LONDON LTD
- Publication Type:
- Journal Article
- Citation:
- Osteoporos Int, 2022, 33, (3), pp. 541-548
- Issue Date:
- 2022-03
Closed Access
Filename | Description | Size | |||
---|---|---|---|---|---|
Predictive performance of the Garvan Fracture Risk Calculator a registry-based cohort study..pdf | Published version | 902.22 kB | Adobe PDF |
Copyright Clearance Process
- Recently Added
- In Progress
- Closed Access
This item is closed access and not available.
Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Agarwal, A | |
dc.contributor.author | Leslie, WD | |
dc.contributor.author | Nguyen, TV | |
dc.contributor.author | Morin, SN | |
dc.contributor.author | Lix, LM | |
dc.contributor.author | Eisman, JA | |
dc.date.accessioned | 2023-04-06T01:31:01Z | |
dc.date.available | 2021-11-23 | |
dc.date.available | 2023-04-06T01:31:01Z | |
dc.date.issued | 2022-03 | |
dc.identifier.citation | Osteoporos Int, 2022, 33, (3), pp. 541-548 | |
dc.identifier.issn | 0937-941X | |
dc.identifier.issn | 1433-2965 | |
dc.identifier.uri | http://hdl.handle.net/10453/169241 | |
dc.description.abstract | UNLABELLED: The G arvan Fracture Risk Calculator predicts risk of osteoporotic fractures. We evaluated its predictive performance in 16,682 women and 2839 men from Manitoba, Canada, and found significant risk stratification, with a strong gradient across scores. The tool outperformed clinical risk factors and bone mineral density for fracture risk stratification. INTRODUCTION: The optimal model for fracture risk estimation to guide treatment decision-making remains controversial. Our objective was to evaluate the predictive performance of the Garvan Fracture Risk Calculator (FRC) in a large clinical registry from Manitoba, Canada. METHODS: Using the population-based Manitoba Bone Mineral Density (BMD) registry, we identified women and men aged 50-95 years undergoing baseline BMD assessment from September 1, 2012, onwards. Five-year Garvan FRC predictions were generated from clinical risk factors (CRFs) with and without femoral neck BMD. We identified incident non-traumatic osteoporotic fractures (OFs) and hip fractures (HFs) from population-based healthcare data sources to March 31, 2018. Fracture risk was assessed from area under the receiver operating characteristic curve (AUROC). Cox regression analysis and calibration ratios (5-year observed/predicted) were assessed for risk quintiles. All analyses were sex stratified. RESULTS: We included 16,682 women (mean age 66.6 + / - SD 8.7 years) and 2839 men (mean age 68.7 + / - SD 10.2 years). During a mean observation time of 2.6 years, incident OFs were identified in 681 women and 140 men and HFs in 199 women and 22 men. AUROC showed significant fracture risk stratification with the Garvan FRC. Tool predictions without BMD were better than from age or decreasing weight, and the tool with BMD performed better than BMD alone. Garvan FRC with BMD performed better than without BMD, especially for HF prediction (AUROC 0.86 in women, 0.82 in men). There was a strong gradient of increasing risk across Garvan FRC quintiles (highest versus lowest, hazard ratios women 5.75 and men 3.43 for any OF; women 101.6 for HF). Calibration differences were noted, with both over- and underestimation in risk. CONCLUSIONS: Garvan FRC outperformed CRFs and BMD alone for fracture risk stratification, particularly for HF, but may require recalibration for accurate predictions in this population. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | SPRINGER LONDON LTD | |
dc.relation | http://purl.org/au-research/grants/nhmrc/APP1195305 | |
dc.relation.ispartof | Osteoporos Int | |
dc.relation.isbasedon | 10.1007/s00198-021-06252-3 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 0903 Biomedical Engineering, 1103 Clinical Sciences, 1117 Public Health and Health Services | |
dc.subject.classification | Endocrinology & Metabolism | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Bone Density | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Female | |
dc.subject.mesh | Hip Fractures | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Osteoporotic Fractures | |
dc.subject.mesh | Registries | |
dc.subject.mesh | Risk Assessment | |
dc.subject.mesh | Risk Factors | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Hip Fractures | |
dc.subject.mesh | Registries | |
dc.subject.mesh | Risk Assessment | |
dc.subject.mesh | Risk Factors | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Bone Density | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Osteoporotic Fractures | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Bone Density | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Female | |
dc.subject.mesh | Hip Fractures | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Osteoporotic Fractures | |
dc.subject.mesh | Registries | |
dc.subject.mesh | Risk Assessment | |
dc.subject.mesh | Risk Factors | |
dc.title | Predictive performance of the Garvan Fracture Risk Calculator: a registry-based cohort study. | |
dc.type | Journal Article | |
utslib.citation.volume | 33 | |
utslib.location.activity | England | |
utslib.for | 0903 Biomedical Engineering | |
utslib.for | 1103 Clinical Sciences | |
utslib.for | 1117 Public Health and Health Services | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Engineering and Information Technology | |
pubs.organisational-group | /University of Technology Sydney/Strength - CHT - Health Technologies | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering | |
pubs.organisational-group | /University of Technology Sydney/Centre for Health Technologies (CHT) | |
utslib.copyright.status | closed_access | * |
dc.date.updated | 2023-04-06T01:30:59Z | |
pubs.issue | 3 | |
pubs.publication-status | Published | |
pubs.volume | 33 | |
utslib.citation.issue | 3 |
Abstract:
UNLABELLED: The G arvan Fracture Risk Calculator predicts risk of osteoporotic fractures. We evaluated its predictive performance in 16,682 women and 2839 men from Manitoba, Canada, and found significant risk stratification, with a strong gradient across scores. The tool outperformed clinical risk factors and bone mineral density for fracture risk stratification. INTRODUCTION: The optimal model for fracture risk estimation to guide treatment decision-making remains controversial. Our objective was to evaluate the predictive performance of the Garvan Fracture Risk Calculator (FRC) in a large clinical registry from Manitoba, Canada. METHODS: Using the population-based Manitoba Bone Mineral Density (BMD) registry, we identified women and men aged 50-95 years undergoing baseline BMD assessment from September 1, 2012, onwards. Five-year Garvan FRC predictions were generated from clinical risk factors (CRFs) with and without femoral neck BMD. We identified incident non-traumatic osteoporotic fractures (OFs) and hip fractures (HFs) from population-based healthcare data sources to March 31, 2018. Fracture risk was assessed from area under the receiver operating characteristic curve (AUROC). Cox regression analysis and calibration ratios (5-year observed/predicted) were assessed for risk quintiles. All analyses were sex stratified. RESULTS: We included 16,682 women (mean age 66.6 + / - SD 8.7 years) and 2839 men (mean age 68.7 + / - SD 10.2 years). During a mean observation time of 2.6 years, incident OFs were identified in 681 women and 140 men and HFs in 199 women and 22 men. AUROC showed significant fracture risk stratification with the Garvan FRC. Tool predictions without BMD were better than from age or decreasing weight, and the tool with BMD performed better than BMD alone. Garvan FRC with BMD performed better than without BMD, especially for HF prediction (AUROC 0.86 in women, 0.82 in men). There was a strong gradient of increasing risk across Garvan FRC quintiles (highest versus lowest, hazard ratios women 5.75 and men 3.43 for any OF; women 101.6 for HF). Calibration differences were noted, with both over- and underestimation in risk. CONCLUSIONS: Garvan FRC outperformed CRFs and BMD alone for fracture risk stratification, particularly for HF, but may require recalibration for accurate predictions in this population.
Please use this identifier to cite or link to this item:
Download statistics for the last 12 months
Not enough data to produce graph