种族特定的FRAX模型是以证据为基础的,支持公平护理:对ASBMR工作组关于骨折风险临床算法的ASBMR工作组报告的回应
John A Kanis1,2, Nicholas C Harvey3,4, Mattias Lorentzon5,6
1Mary McKillop Institute for Health Research, Catholic University, AustralianMelbourne, Australia. w.j.pontefract@shef.ac.uk.
概括
针对种族和种族的FRAX®骨折风险模型被推用于美国,以防止对黑人,亚裔和西班牙裔社区的歧视. 固定的骨矿物质密度值也不公平地歧视这些人群.
科学领域:
- 骨健康和骨质疏松症研究
- 临床流行病学 临床流行病学
- 健康 公平 卫生 公平
背景情况:
- 美国骨和矿物研究协会 (ASBMR) 建议从美国FRAX®模型中删除种族/种族调整.
- 这一提案可能会导致不公平的骨折风险评估和治疗决策.
- 现有的FRAX®模型利用种族和种族来改进骨折风险预测.
研究的目的:
- 评估种族和种族不可知的骨折风险算法对不同美国人口的影响.
- 倡导持续使用和改进种族和种族特定的FRAX®模型.
- 解决固定骨矿物质密度干预门的歧视潜力.
主要方法:
- 在骨折风险算法中删除种族和种族调整的影响的分析.
- 对固定骨矿物质密度值的歧视性影响的审查.
- 基于流行病学和生活质量方面的考虑,制定立场陈述.
主要成果:
- 美国的种族和种族不可知的FRAX®模型将不公平地歧视黑人,亚洲人和西班牙裔个人.
- 固定的骨矿物质密度干预门也表明对这些同一个社区的歧视偏见.
- 对于特定种族和种族的模型,需要更新关于骨折和死亡风险的数据.
结论:
- 保持种族和种族特定的FRAX®模型对于美国公平的骨折风险评估至关重要.
- 干预策略应避免固定骨矿物质密度值,使少数群体处于不利地位.
- 国际骨质疏松症基金会 (IOF) 和ESCEO的认可强调了这些发现对全球骨质疏松症管理的重要性.
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