| Title |
SIGN Guidelines for Scotland: BMD Versus FRAX Versus QFracture
|
|---|---|
| Published in |
Calcified Tissue International, December 2015
|
| DOI | 10.1007/s00223-015-0092-4 |
| Pubmed ID | |
| Authors |
John A. Kanis, Juliet Compston, Cyrus Cooper, Nicholas C. Harvey, Helena Johansson, Anders Odén, Eugene V. McCloskey |
| Abstract |
Scottish Intercollegiate Guidelines Network (SIGN) recently issued guidance on the management of osteoporosis and the prevention of fragility fractures. The aim of this paper was to critically review the guidance. The SIGN guidance utilises risk factors for fracture as an initial step for assessment, but recommends treatment only in individuals with a T-score of -2.5. There are many problems with the sole use of BMD as the sole gateway to treatment. Moreover, the assessment tools to determine risk (FRAX or QFracture) are not designed to detect osteoporosis but rather fracture risk. Whereas SIGN assumes that FRAX overestimates fracture probability, there are compelling reasons to believe that the disparity is related to the inadequate calibration of QFracture. The disparities make the use of a single threshold for BMD testing problematic. The SIGN guidance for men at high risk of fracture provides a set of confused and inconsistent recommendations that are in direct conflict with regulatory authorizations and is likely to increase further the large treatment gap in men. For women, the number of women eligible for treatment (i.e. with osteoporosis) is 81,700 with the use of FRAX but only 12,300 with QFracture representing 8.2 and 1.2 % of the total population at risk, respectively. We conclude that serious problems with the SIGN guidance preclude its implementation. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 49 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 7 | 14% |
| Student > Master | 6 | 12% |
| Student > Doctoral Student | 5 | 10% |
| Student > Postgraduate | 4 | 8% |
| Professor | 3 | 6% |
| Other | 11 | 22% |
| Unknown | 13 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 39% |
| Nursing and Health Professions | 6 | 12% |
| Biochemistry, Genetics and Molecular Biology | 2 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Immunology and Microbiology | 1 | 2% |
| Other | 3 | 6% |
| Unknown | 17 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 December 2015.
All research outputs
#20,298,249
of 22,835,198 outputs
Outputs from Calcified Tissue International
#1,569
of 1,759 outputs
Outputs of similar age
#326,296
of 389,038 outputs
Outputs of similar age from Calcified Tissue International
#14
of 20 outputs
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