Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores

摘要: Objective To develop and validate two new fracture risk algorithms (QFractureScores) for estimating the individual of osteoporotic or hip over 10 years. Design Prospective open cohort study with routinely collected data from 357 general practices to scores 178 scores. Setting General in England Wales. Participants 1 183 663 women 1 174 232 men aged 30-85 derivation cohort, who contributed 7 898 208 8 049 306 person years observation, respectively. There were 24 350 incident diagnoses 7934 men, 9302 5424 men. Main outcome measures First (incident) diagnosis (vertebral, distal radius, hip) recorded practice records. Results Use hormone replacement therapy (HRT), age, body mass index (BMI), smoking status, alcohol use, parental history osteoporosis, rheumatoid arthritis, cardiovascular disease, type 2 diabetes, asthma, tricyclic antidepressants, corticosteroids, falls, menopausal symptoms, chronic liver gastrointestinal malabsorption, other endocrine disorders significantly independently associated women. Some variables but not fracture. The predictors BMI, disease. algorithm had best performance among It explained 63.94% variation 63.19% D statistic values discrimination highest (2.73) (2.68) twice magnitude corresponding ROC statistics also high: 0.89 0.86 versus 0.79 0.69, respectively, outcome. well calibrated predicted risks closely matching observed risks. QFractureScore good calibration compared FRAX (fracture assessment) algorithm. Conclusions These can predict primary care populations UK without laboratory measurements are therefore suitable use both clinical settings self assessment (www.qfracture.org). QFractureScores could be used identify patients at high might benefit interventions reduce their risk.