閉経後の女性の5年間の股関節骨折リスクに関連する要因
John Robbins1, Aaron K Aragaki, Charles Kooperberg
1Department of Internal Medicine, University of California at Davis School of Medicine, Sacramento, CA 95817, USA. jarobbins@ucdavis.edu
JAMA
|November 29, 2007
まとめ
新しいアルゴリズムは,11の一般的な臨床的要因を使用して,閉経後の女性の5年間の股関節骨折リスクを予測します. このツールは,標的型予防戦略のための高リスクの個人を特定するのに役立ちます.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- エピデミオロジー エピデミオロジー
- 予防医学は,予防的な医療です.
背景:
- 米国では毎年3万29000件を超える股関節骨折が発生し,著しい罹病率,死亡率,医療費がかかっています.
- 高リスクの個人を早期に特定することは,効果的な股関節骨折予防戦略に不可欠です.
研究 の 目的:
- 閉経後の女性の5年間の股関節骨折リスクに関する予測アルゴリズムの開発と検証.
- 股関節骨折リスクに貢献する重要な臨床的要因を特定する.
主な方法:
- 女性の健康イニシアチブ (WHI) の観察研究における93,676人の女性のデータを活用して,アルゴリズムを開発しました.
- WHI臨床試験の女性68,132人のデータを用いてアルゴリズムを検証しました.
- 受信機動作特性 (ROC) 曲線と曲線下の面積 (AUC) メトリックを使用して予測精度を評価しました.
主要な成果:
- ヒップ骨折を予測する11の要因を特定した:年齢,自己報告した健康,体重,身長,人種/民族,身体活動,以前の骨折,親の骨折,喫煙,コルチコステロイド使用,糖尿病.
- アルゴリズムは,検証コホートで80% (95%CI,0.77-0.82) のAUCを達成しました.
- 実践的なリスク評価のための簡素化されたポイントスコアシステムを開発しました.
結論:
- 11つの容易に入手可能な臨床的要因に基づいたアルゴリズムは,さまざまな閉経後の女性の5年間の股関節骨折リスクを予測することができます.
- アルゴリズムは,骨密度評価に匹敵する予測性能を示しています.
- この予測ツールが治療決定に与える臨床的有用性と影響を評価するために,さらなる研究が必要である.
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