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Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey
BACKGROUND: There is an ongoing discussion about incorporating additional risk factors to established WHO fracture risk assessment tool (FRAX) to improve the prediction accuracy in clinical subgroups. We aimed to reach an expert consensus on possible additional predictive parameters for specific cli...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849295/ https://www.ncbi.nlm.nih.gov/pubmed/31742245 http://dx.doi.org/10.1186/s41927-019-0099-y |
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author | Bodmer, Nicolas S. Häuselmann, Hans Jörg Frey, Diana Aeberli, Daniel Bachmann, Lucas M. |
author_facet | Bodmer, Nicolas S. Häuselmann, Hans Jörg Frey, Diana Aeberli, Daniel Bachmann, Lucas M. |
author_sort | Bodmer, Nicolas S. |
collection | PubMed |
description | BACKGROUND: There is an ongoing discussion about incorporating additional risk factors to established WHO fracture risk assessment tool (FRAX) to improve the prediction accuracy in clinical subgroups. We aimed to reach an expert consensus on possible additional predictive parameters for specific clinical subgroups. METHODS: Two-round modified Delphi survey: We generated a shortlist of experts from the authors’ lists of the pertinent literature and complemented the list with experts known to the authors. Participants were asked to name possible relevant risk factors besides the FRAX-parameters for the occurrence of osteoporotic fractures. Experts specified these possible predictors for specific subgroups of patients. In the second round the expert panel was asked to weight each parameter of every subgroup assigning a number between one (not important) to ten (very important). We defined the threshold for an expert consensus if the interquartile range (IQR) of a predictor was ≤2. The cut-off value of the median attributed weights for a relevant predictor was set at ≥7. RESULTS: Eleven experts of seven countries completed both rounds of the Delphi. The participants agreed on nine additional parameters for seven categories. For the category “secondary osteoporosis”, “older adults” and “nursing home patients”, there was a consensus that history of previous falls was relevant, while for men and postmenopausal women, there was a consensus that the spine fracture status was important. For the group “primary and secondary osteoporosis” the experts agreed on the parameters “high risk of falls”, “lumbar spine bone mineral density (BMD)” and “sarcopenia”. CONCLUSION: This Delphi survey reached a consensus on various parameters that could be used to refine the currently existing FRAX for specific clinical situations or patient groups. The results may be useful for studies aiming at improving the predictive properties of instruments for fracture prediction. |
format | Online Article Text |
id | pubmed-6849295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68492952019-11-18 Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey Bodmer, Nicolas S. Häuselmann, Hans Jörg Frey, Diana Aeberli, Daniel Bachmann, Lucas M. BMC Rheumatol Research Article BACKGROUND: There is an ongoing discussion about incorporating additional risk factors to established WHO fracture risk assessment tool (FRAX) to improve the prediction accuracy in clinical subgroups. We aimed to reach an expert consensus on possible additional predictive parameters for specific clinical subgroups. METHODS: Two-round modified Delphi survey: We generated a shortlist of experts from the authors’ lists of the pertinent literature and complemented the list with experts known to the authors. Participants were asked to name possible relevant risk factors besides the FRAX-parameters for the occurrence of osteoporotic fractures. Experts specified these possible predictors for specific subgroups of patients. In the second round the expert panel was asked to weight each parameter of every subgroup assigning a number between one (not important) to ten (very important). We defined the threshold for an expert consensus if the interquartile range (IQR) of a predictor was ≤2. The cut-off value of the median attributed weights for a relevant predictor was set at ≥7. RESULTS: Eleven experts of seven countries completed both rounds of the Delphi. The participants agreed on nine additional parameters for seven categories. For the category “secondary osteoporosis”, “older adults” and “nursing home patients”, there was a consensus that history of previous falls was relevant, while for men and postmenopausal women, there was a consensus that the spine fracture status was important. For the group “primary and secondary osteoporosis” the experts agreed on the parameters “high risk of falls”, “lumbar spine bone mineral density (BMD)” and “sarcopenia”. CONCLUSION: This Delphi survey reached a consensus on various parameters that could be used to refine the currently existing FRAX for specific clinical situations or patient groups. The results may be useful for studies aiming at improving the predictive properties of instruments for fracture prediction. BioMed Central 2019-11-12 /pmc/articles/PMC6849295/ /pubmed/31742245 http://dx.doi.org/10.1186/s41927-019-0099-y Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Bodmer, Nicolas S. Häuselmann, Hans Jörg Frey, Diana Aeberli, Daniel Bachmann, Lucas M. Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title | Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title_full | Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title_fullStr | Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title_full_unstemmed | Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title_short | Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey |
title_sort | expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – delphi survey |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849295/ https://www.ncbi.nlm.nih.gov/pubmed/31742245 http://dx.doi.org/10.1186/s41927-019-0099-y |
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