在绝经后妇女中,与5年关节骨折风险相关的因素
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
概括
一个新的算法使用11个常见的临床因素预测绝经后妇女的5年关节骨折风险. 该工具有助于识别高风险个体,以制定有针对性的预防策略.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 预防医学 预防医学
背景情况:
- 在美国,每年发生的关节骨折超过329,000,导致严重的发病率,死亡率和医疗费用.
- 早期识别高风险个体对于有效的关节骨折预防策略至关重要.
研究的目的:
- 开发和验证一个预测算法,以确定绝经后妇女关节骨折的5年风险.
- 确定导致关节骨折风险的关键临床因素.
主要方法:
- 在妇女健康倡议 (WHI) 观察研究中利用了来自93,676名妇女的数据来开发算法.
- 通过WHI临床试验中的68,132名女性的数据验证了算法.
- 使用接收器运行特征 (ROC) 曲线和曲线下的面积 (AUC) 度量来评估预测准确性.
主要成果:
- 确定了11个预测关节骨折的因素:年龄,自我报告的健康状况,体重,身高,种族/种族,身体活动,先前骨折,父母骨折,吸烟,皮质类固醇使用和糖尿病.
- 该算法在验证队列中实现了80% (95% CI,0.77-0.82) 的AUC.
- 开发了一个简化的点评系统,用于实际的风险评估.
结论:
- 一个基于11个随时可用的临床因素的算法可以预测各种绝经后妇女的5年关节骨折风险.
- 该算法展示了与骨密度评估相比较的预测性能.
- 需要进一步的研究来评估这种预测工具对治疗决策的临床实用性和影响.
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