L Vandenput1,2, H Johansson1,3, E V McCloskey3,4, E Liu1, K E Åkesson5,6, F A Anderson7, R Azagra8,9,10, C L Bager11, C Beaudart12, H A Bischoff-Ferrari13,14, E Biver15, O Bruyère12, J A Cauley16, J R Center17,18,19, R Chapurlat20, C Christiansen11, C Cooper21,22,23, C J Crandall24, S R Cummings25, J A P da Silva26,27, B Dawson-Hughes28, A Diez-Perez29, A B Dufour30,31, J A Eisman18,19,32, P J M Elders33, S Ferrari15, Y Fujita34, S Fujiwara35, C-C Glüer36, I Goldshtein37,38, D Goltzman39, V Gudnason40,41, J Hall42, D Hans43, M Hoff44,45, R J Hollick46, M Huisman47,48, M Iki34, S Ish-Shalom49, G Jones50, M K Karlsson5,51, S Khosla52, D P Kiel30,31, W-P Koh53,54, F Koromani55,56, M A Kotowicz57,58,59, H Kröger60,61, T Kwok62,63, O Lamy64,65, A Langhammer66, B Larijani67, K Lippuner68, D Mellström69,70, T Merlijn33, A Nordström71,72, P Nordström73, T W O'Neill74,75, B Obermayer-Pietsch76,77, C Ohlsson2,78, E S Orwoll79, J A Pasco80,81,82,83, F Rivadeneira55, B Schei84,85, A-M Schott86, E J Shiroma87, K Siggeirsdottir40,88, E M Simonsick89, E Sornay-Rendu90, R Sund61, K M A Swart33, P Szulc20, J Tamaki91, D J Torgerson92, N M van Schoor47, T P van Staa93, J Vila94, N J Wareham95, N C Wright96, N Yoshimura97, M C Zillikens55, M Zwart98,99,100, N C Harvey101,102, M Lorentzon1,103,104, W D Leslie105, J A Kanis106,107,108. 1. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. 2. Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. 4. MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK. 5. Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden. 6. Department of Orthopedics, Skåne University Hospital, Malmö, Sweden. 7. GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA. 8. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. 9. Health Center Badia del Valles, Catalan Institute of Health, Barcelona, Spain. 10. GROIMAP (Research Group), Unitat de Suport a La Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Santa Coloma de Gramenet, Barcelona, Spain. 11. Nordic Bioscience A/S, Herlev, Denmark. 12. WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. 13. Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland. 14. Centre On Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland. 15. Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. 16. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, USA. 17. Bone Biology, Healthy Ageing Theme, Garvan Institute of Medical Research, Sydney, NSW, Australia. 18. St Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia. 19. School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia. 20. INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France. 21. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 22. National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK. 23. National Institute for Health Research Oxford Biomedical Research Unit, , University of Oxford, Oxford, UK. 24. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. 25. San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA. 26. Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 27. Rheumatology Department, University Hospital and University of Coimbra, Coimbra, Portugal. 28. Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA, USA. 29. Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain. 30. Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA. 31. Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. 32. Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, Sydney, NSW, Australia. 33. Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. 34. Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan. 35. Department of Pharmacy, Yasuda Women's University, Hiroshima, Japan. 36. Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany. 37. Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel. 38. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 39. Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada. 40. Icelandic Heart Association, Kopavogur, Iceland. 41. University of Iceland, Reykjavik, Iceland. 42. MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK. 43. Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland. 44. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway. 45. Department of Rheumatology, St Olavs Hospital, Trondheim, Norway. 46. Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK. 47. Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 48. Department of Sociology, VU University, Amsterdam, The Netherlands. 49. Endocrine Clinic, Elisha Hospital, Haifa, Israel. 50. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 51. Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden. 52. Robert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA. 53. Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 54. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore. 55. Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 56. Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 57. IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia. 58. Barwon Health, Geelong, VIC, Australia. 59. Department of Medicine - Western Health, The University of Melbourne, St Albans, Victoria, Australia. 60. Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland. 61. Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland. 62. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 63. Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 64. Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland. 65. Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland. 66. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway. 67. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 68. Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland. 69. Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 70. Geriatric Medicine, Sahlgrenska University Hospital Mölndal, Mölndal, Sweden. 71. Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 72. School of Sport Sciences, Arctic University of Norway, Tromsø, Norway. 73. Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden. 74. National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. 75. Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK. 76. Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria. 77. Center for Biomarker Research in Medicine, Graz, Austria. 78. Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden. 79. Department of Medicine, Oregon Health and Science University, Portland, OR, USA. 80. Institute for Physical and Mental Health and Clinical Translation (IMPACT), Deakin University, Geelong, Australia. 81. Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia. 82. Barwon Health, Geelong, Australia. 83. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 84. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. 85. Department of Gynecology, St Olavs Hospital, Trondheim, Norway. 86. Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France. 87. Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA. 88. Janus Rehabilitation, Reykjavik, Iceland. 89. Translational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD, USA. 90. INSERM Research Unit 1033, Lyon, France. 91. Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan. 92. York Trials Unit, Department of Health Sciences, University of York, York, UK. 93. Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK. 94. Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain. 95. MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. 96. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. 97. Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan. 98. Health Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain. 99. Department of Medical Sciences, University of Girona, Girona, Spain. 100. GROIMAP (Research Group), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain. 101. MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK. 102. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 103. Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. 104. Geriatric Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Mölndal, Sweden. 105. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada. 106. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.pontefract@shef.ac.uk. 107. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. w.j.pontefract@shef.ac.uk. 108. Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. w.j.pontefract@shef.ac.uk.
Abstract
We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. INTRODUCTION: The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. METHODS: A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. RESULTS: Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. CONCLUSIONS: These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. INTRODUCTION: The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. METHODS: A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. RESULTS: Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. CONCLUSIONS: These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
Authors: Gunnar Sigurdsson; Thor Aspelund; Milan Chang; Birna Jonsdottir; Sigurdur Sigurdsson; Gudny Eiriksdottir; Adalsteinn Gudmundsson; Tamara B Harris; Vilmundur Gudnason; Thomas F Lang Journal: Bone Date: 2006-06-21 Impact factor: 4.398
Authors: John A Kanis; Nicholas C Harvey; Helena Johansson; Enwu Liu; Liesbeth Vandenput; Mattias Lorentzon; William D Leslie; Eugene V McCloskey Journal: Aging Clin Exp Res Date: 2020-02-11 Impact factor: 3.636
Authors: John A Kanis; Nicholas C Harvey; Cyrus Cooper; Helena Johansson; Anders Odén; Eugene V McCloskey Journal: Arch Osteoporos Date: 2016-07-27 Impact factor: 2.617
Authors: J A Kanis; A Oden; O Johnell; H Johansson; C De Laet; J Brown; P Burckhardt; C Cooper; C Christiansen; S Cummings; J A Eisman; S Fujiwara; C Glüer; D Goltzman; D Hans; M-A Krieg; A La Croix; E McCloskey; D Mellstrom; L J Melton; H Pols; J Reeve; K Sanders; A-M Schott; A Silman; D Torgerson; T van Staa; N B Watts; N Yoshimura Journal: Osteoporos Int Date: 2007-02-24 Impact factor: 4.507
Authors: J A Kanis; H Johansson; N C Harvey; V Gudnason; G Sigurdsson; K Siggeirsdottir; M Lorentzon; E Liu; L Vandenput; E V McCloskey Journal: Osteoporos Int Date: 2020-07-01 Impact factor: 4.507
Authors: Matthew J Page; Joanne E McKenzie; Patrick M Bossuyt; Isabelle Boutron; Tammy C Hoffmann; Cynthia D Mulrow; Larissa Shamseer; Jennifer M Tetzlaff; Elie A Akl; Sue E Brennan; Roger Chou; Julie Glanville; Jeremy M Grimshaw; Asbjørn Hróbjartsson; Manoj M Lalu; Tianjing Li; Elizabeth W Loder; Evan Mayo-Wilson; Steve McDonald; Luke A McGuinness; Lesley A Stewart; James Thomas; Andrea C Tricco; Vivian A Welch; Penny Whiting; David Moher Journal: BMJ Date: 2021-03-29