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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Risk assessment tools to identify women with increased risk of osteoporotic fracture: complexity or simplicity? A systematic review

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  3. Women's lived experiences of learning to live with osteoporosis: a longitudinal qualitative study

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  • Katrine Hass Rubin
  • Teresa Friis-Holmberg
  • Anne Pernille Hermann
  • Bo Abrahamsen
  • Kim Brixen
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A huge number of risk assessment tools have been developed. Far from all have been validated in external studies, more of them have absence of methodological and transparent evidence, and few are integrated in national guidelines. Therefore, we performed a systematic review to provide an overview of existing valid and reliable risk assessment tools for prediction of osteoporotic fractures. Additionally, we aimed to determine if the performance of each tool was sufficient for practical use, and last, to examine whether the complexity of the tools influenced their discriminative power. We searched PubMed, Embase, and Cochrane databases for papers and evaluated these with respect to methodological quality using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) checklist. A total of 48 tools were identified; 20 had been externally validated, however, only six tools had been tested more than once in a population-based setting with acceptable methodological quality. None of the tools performed consistently better than the others and simple tools (i.e., the Osteoporosis Self-assessment Tool [OST], Osteoporosis Risk Assessment Instrument [ORAI], and Garvan Fracture Risk Calculator [Garvan]) often did as well or better than more complex tools (i.e., Simple Calculated Risk Estimation Score [SCORE], WHO Fracture Risk Assessment Tool [FRAX], and Qfracture). No studies determined the effectiveness of tools in selecting patients for therapy and thus improving fracture outcomes. High-quality studies in randomized design with population-based cohorts with different case mixes are needed.
Original languageEnglish
JournalJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Volume28
Issue number8
Pages (from-to)1701-17
Number of pages17
ISSN0884-0431
DOIs
Publication statusPublished - Aug 2013

ID: 39693239