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The Danish Nationwide osteoporosis cohort trials environment (NOCTE) - a DXA dataset for the 1900-1960 birth cohort
Benjamin Bakke Hansen1, Bryan Haddock2, Niklas Rye Jørgensen3
1OPEN-Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Background:
Osteoporosis is a common, underdiagnosed condition causing increased risk of fracture. While dual-energy X-ray absorptiometry (DXA) is the diagnostic standard, this may not be successfully targeted to individuals at the highest risk. This study presents an extensive nationwide dataset characterizing DXA-scanning practices in Denmark.
Methodology:
In this study, we identified all Danish residents from the birth cohort 1900-1960, with a first DXA scan between 2010-2022 to form the Nationwide Osteoporosis Cohort Trials Environment (NOCTE) dataset. These individuals were matched 1:5 to a non-scanned reference population by birth year, sex, and region of residence. Individual data were linked to national registers for comprehensive sociodemographic and clinical information.
Results:
The final cohort included 263,651 individuals who underwent DXA scanning. At their first scan, 33% of women and 17% of men had osteoporosis. Compared to the matched reference, the scanned cohort had similar socioeconomic profiles but substantially different clinical profiles. Scanned individuals had a much higher prevalence of prior major osteoporotic fractures, prior systemic glucocorticoid exposure, and overall comorbidity burden.
Conclusion:
Referral for DXA in Denmark is driven by clinical risk rather than socioeconomic status, reflecting an equitable resource allocation. However, a significant diagnostic gap persists, as many high-risk individuals with prior fractures did not receive a DXA. The NOCTE cohort is a new, powerful resource for developing strategies to help close this gap.
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