clinical tool to identify older women with back pain at high risk of osteoporotic vertebral fractures (Vfrac): a population-based cohort study with exploratory economic evaluation.
Background osteoporotic vertebral fractures (OVFs) identify people at high risk of future fractures, but despite this, less than a third come to clinical attention. The objective of this study was to develop a clinical tool to aid health care professionals decide which older women with back pain sho...
| Publicado en: | Age & Ageing Vol. 51; no. 3; pp. 1 - 9 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Mar2022
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=156085615&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 156085615 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Mar2022 vid: 51 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 156085615 10.1093/ageing/afac031 ppf: 1 ppct: 8 formats: tig: atl: clinical tool to identify older women with back pain at high risk of osteoporotic vertebral fractures (Vfrac): a population-based cohort study with exploratory economic evaluation. aug: au: Khera, Tarnjit Hunt, Linda P Davis, Sarah Gooberman-Hill, Rachael Thom, Howard Xu, Yixin Paskins, Zoe Peters, Tim J Tobias, Jon H Clark, Emma M affil: Translational Health Sciences, Bristol Medical School, University of Bristol , Bristol, UK School of Health & Related Research, University of Sheffield , Sheffield, UK NIHR Bristol Biomedical Research Centre , Bristol, UK Population Health Sciences, Bristol Medical School, University of Bristol , Bristol, UK School of Medicine, Keele University , Staffordshire, UK Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust , Stoke-on-Trent, UK MRC Integrative Epidemiology Unit, University of Bristol , UK North Bristol NHS Trust , Bristol, UK su: Self-evaluation Cost effectiveness Women's health Old age Spine radiography Experimental design Research Physical diagnosis Research methodology Backache Osteoporosis Risk assessment Logistic regression analysis Receiver operating characteristic curves Sensitivity & specificity (Statistics) Decision making in clinical medicine Bone fractures Vertebral fractures sug: subj: Self-evaluation Cost effectiveness Women's health Old age Spine radiography Experimental design Research Physical diagnosis Research methodology Backache Osteoporosis Risk assessment Logistic regression analysis Receiver operating characteristic curves Sensitivity & specificity (Statistics) Decision making in clinical medicine Bone fractures Vertebral fractures keyword: back pain cohort study older people vertebral fractures Vfrac back pain cohort study older people vertebral fractures Vfrac ab: Background osteoporotic vertebral fractures (OVFs) identify people at high risk of future fractures, but despite this, less than a third come to clinical attention. The objective of this study was to develop a clinical tool to aid health care professionals decide which older women with back pain should have a spinal radiograph. Methods a population-based cohort of 1,635 women aged 65+ years with self-reported back pain in the previous 4 months were recruited from primary care. Exposure data were collected through self-completion questionnaires and physical examination, including descriptions of back pain and traditional risk factors for osteoporosis. Outcome was the presence/absence of OVFs on spinal radiographs. Logistic regression models identified independent predictors of OVFs, with the area under the (receiver operating) curve calculated for the final model, and a cut-point was identified. Results mean age was 73.9 years and 209 (12.8%) had OVFs. The final Vfrac model comprised 15 predictors of OVF, with an AUC of 0.802 (95% CI: 0.764–0.840). Sensitivity was 72.4% and specificity was 72.9%. Vfrac identified 93% of those with more than one OVF and two-thirds of those with one OVF. Performance was enhanced by inclusion of self-reported back pain descriptors, removal of which reduced AUC to 0.742 (95% CI: 0.696–0.788) and sensitivity to 66.5%. Health economic modelling to support a future trial was favourable. Conclusions the Vfrac clinical tool appears to be valid and is improved by the addition of self-reported back pain symptoms. The tool now requires testing to establish real-world clinical and cost-effectiveness. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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