Prediction models of prevalent radiographic vertebral fractures among older men.

Prediction models of prevalent radiographic vertebral fractures among older men. Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry Schousboe, J. T., Rosen, H. R., Vokes, T. J., Cauley, J. A., Cummings, S. R., Nevitt, M. C., Black, D. M., Orwoll, E. S., Kado, D. M., Ensrud, K. E. 2013; 17 (4): 449-57

Abstract

No studies have compared how well different prediction models discriminate older men who have a radiographic prevalent vertebral fracture (PVFx) from those who do not. We used area under receiver operating characteristic curves and a net reclassification index to compare how well regression-derived prediction models and nonregression prediction tools identify PVFx among men age =65 yr with femoral neck T-score of -1.0 or less enrolled in the Osteoporotic Fractures in Men Study. The area under receiver operating characteristic for a model with age, bone mineral density, and historical height loss (HHL) was 0.682 compared with 0.692 for a complex model with age, bone mineral density, HHL, prior non-spine fracture, body mass index, back pain, grip strength, smoking, and glucocorticoid use (p values for difference in 5 bootstrapped samples 0.14-0.92). This complex model, using a cutpoint prevalence of 5%, correctly reclassified only a net 5.7% (p = 0.13) of men as having or not having a PVFx compared with a simple criteria list (age = 80 yr, HHL >4 cm, or glucocorticoid use). In conclusion, simple criteria identify older men with PVFx and regression-based models. Future research to identify additional risk factors that more accurately identify older men with PVFx is needed.

View details for DOI 10.1016/j.jocd.2013.09.020

View details for PubMedID 24289883

View details for PubMedCentralID PMC4035457