Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study

Autor: Sören Möller, Kim Brixen, Mikkel Høiberg, Jeppe Gram, Katrine Hass Rubin, Teresa Holmberg, Mette Juel Rothmann, Claus-Christian Glüer, Reinhard Barkmann, Anne Pernille Hermann, Mickael Bech
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Hip Fractures/epidemiology
FRAX
Randomization
Endocrinology
Diabetes and Metabolism
Denmark
Osteoporosis
Population
030209 endocrinology & metabolism
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Absorptiometry
Photon
Mass Screening/methods
Osteoporosis
Postmenopausal/complications
Risk Factors
Internal medicine
Surveys and Questionnaires
medicine
Absorptiometry
Photon/methods
Humans
Mass Screening
030212 general & internal medicine
Risk Assessment/methods
education
Osteoporosis
Postmenopausal
Aged
Aged
80 and over
education.field_of_study
business.industry
Hip Fractures
Incidence (epidemiology)
Incidence
Osteoporotic Fractures/epidemiology
medicine.disease
Denmark/epidemiology
Rheumatology
Osteoporosis screening
Socioeconomic Factors
Orthopedic surgery
Physical therapy
Female
business
Osteoporotic Fractures
Follow-Up Studies
Zdroj: Rubin, K H, Rothmann, M J, Holmberg, T, Høiberg, M, Möller, S, Barkmann, R, Glüer, C C, Hermann, A P, Bech, M, Gram, J & Brixen, K 2018, ' Effectiveness of a two-step population-based osteoporosis screening program using FRAX : the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study ', Osteoporosis International, vol. 29, no. 3, pp. 567–578 . https://doi.org/10.1007/s00198-017-4326-3
ISSN: 1433-2965
Popis: Summary: The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. Introduction: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. Methods: Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion took place from February 2010 to November 2011. Participants received a self-administered questionnaire, and women in the screening group with a FRAX score ≥ 15% (major osteoporotic fractures) were invited to a DXA scan. Primary outcome was incident clinical fractures. Intention-to-treat analysis and two per-protocol analyses were performed. Results: A total of 3416 fractures were observed during a median follow-up of 5 years. No significant differences were found in the intention-to-treat analyses with 34,229 women included aged 65–80 years. The per-protocol analyses showed a risk reduction in the group that underwent DXA scanning compared to women in the control group with a FRAX ≥ 15%, in regard to major osteoporotic fractures, hip fractures, and all fractures. The risk reduction was most pronounced for hip fractures (adjusted SHR 0.741, p = 0.007). Conclusions: Compared to an office-based case-finding strategy, the two-step systematic screening strategy had no overall effect on fracture incidence. The two-step strategy seemed, however, to be beneficial in the group of women who were identified by FRAX as moderate- or high-risk patients and complied with DXA.
Databáze: OpenAIRE
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