Fracture risk as determined by prospective and retrospective study designs

M. R. Stegman, Robert R. Recker, K. M. Davies, R. A. Ryan, R. P. Heaney

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Both retrospectively and prospectively designed studies consistently show low bone mass and/or bone mineral content (BMC) to be risk factor for low-trauma fractures in postmenopausal women. Along with the reports of such studies there has been concern expressed that BMC measurements overlap between fracture groups, i.e., some women with high BMC develop fractures and some women with low BMC do not. In these commonly used epidemiologic study designs, BMC does not discriminate between those who have and have not experienced the untoward event at some level of the exposure factor. The ability to discriminate is more properly determined by the sensitivity and specificity of the measured value. To contrast the concepts of risk and sensitivity, a nested case-control study was conducted within a 24-year cohort study of women at risk for osteoporosis. We found that for each 1.0 decrement of BMC z-scores, the adjusted relative risk for the prospective study design was 1.67, while the odds ratio obtained from the most recent BMC z-score measurements was 1.87. A receiver operating characteristic (ROC) curve, calculated from the nested case-control study data, showed that BMC z-scores, measured after low-trauma fracture, have both low sensitivity and low specificity to detect existing fracture status.

Original languageEnglish
Pages (from-to)290-297
Number of pages8
JournalOsteoporosis International
Volume2
Issue number6
DOIs
StatePublished - Nov 1992

Fingerprint

Bone Density
Retrospective Studies
Prospective Studies
Case-Control Studies
Sensitivity and Specificity
Wounds and Injuries
ROC Curve
Osteoporosis
Epidemiologic Studies
Cohort Studies
Odds Ratio
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Fracture risk as determined by prospective and retrospective study designs. / Stegman, M. R.; Recker, Robert R.; Davies, K. M.; Ryan, R. A.; Heaney, R. P.

In: Osteoporosis International, Vol. 2, No. 6, 11.1992, p. 290-297.

Research output: Contribution to journalArticle

Stegman, M. R. ; Recker, Robert R. ; Davies, K. M. ; Ryan, R. A. ; Heaney, R. P. / Fracture risk as determined by prospective and retrospective study designs. In: Osteoporosis International. 1992 ; Vol. 2, No. 6. pp. 290-297.
@article{6dace8302fbf4330be0804dc1cb80823,
title = "Fracture risk as determined by prospective and retrospective study designs",
abstract = "Both retrospectively and prospectively designed studies consistently show low bone mass and/or bone mineral content (BMC) to be risk factor for low-trauma fractures in postmenopausal women. Along with the reports of such studies there has been concern expressed that BMC measurements overlap between fracture groups, i.e., some women with high BMC develop fractures and some women with low BMC do not. In these commonly used epidemiologic study designs, BMC does not discriminate between those who have and have not experienced the untoward event at some level of the exposure factor. The ability to discriminate is more properly determined by the sensitivity and specificity of the measured value. To contrast the concepts of risk and sensitivity, a nested case-control study was conducted within a 24-year cohort study of women at risk for osteoporosis. We found that for each 1.0 decrement of BMC z-scores, the adjusted relative risk for the prospective study design was 1.67, while the odds ratio obtained from the most recent BMC z-score measurements was 1.87. A receiver operating characteristic (ROC) curve, calculated from the nested case-control study data, showed that BMC z-scores, measured after low-trauma fracture, have both low sensitivity and low specificity to detect existing fracture status.",
author = "Stegman, {M. R.} and Recker, {Robert R.} and Davies, {K. M.} and Ryan, {R. A.} and Heaney, {R. P.}",
year = "1992",
month = "11",
doi = "10.1007/BF01623185",
language = "English",
volume = "2",
pages = "290--297",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "6",

}

TY - JOUR

T1 - Fracture risk as determined by prospective and retrospective study designs

AU - Stegman, M. R.

AU - Recker, Robert R.

AU - Davies, K. M.

AU - Ryan, R. A.

AU - Heaney, R. P.

PY - 1992/11

Y1 - 1992/11

N2 - Both retrospectively and prospectively designed studies consistently show low bone mass and/or bone mineral content (BMC) to be risk factor for low-trauma fractures in postmenopausal women. Along with the reports of such studies there has been concern expressed that BMC measurements overlap between fracture groups, i.e., some women with high BMC develop fractures and some women with low BMC do not. In these commonly used epidemiologic study designs, BMC does not discriminate between those who have and have not experienced the untoward event at some level of the exposure factor. The ability to discriminate is more properly determined by the sensitivity and specificity of the measured value. To contrast the concepts of risk and sensitivity, a nested case-control study was conducted within a 24-year cohort study of women at risk for osteoporosis. We found that for each 1.0 decrement of BMC z-scores, the adjusted relative risk for the prospective study design was 1.67, while the odds ratio obtained from the most recent BMC z-score measurements was 1.87. A receiver operating characteristic (ROC) curve, calculated from the nested case-control study data, showed that BMC z-scores, measured after low-trauma fracture, have both low sensitivity and low specificity to detect existing fracture status.

AB - Both retrospectively and prospectively designed studies consistently show low bone mass and/or bone mineral content (BMC) to be risk factor for low-trauma fractures in postmenopausal women. Along with the reports of such studies there has been concern expressed that BMC measurements overlap between fracture groups, i.e., some women with high BMC develop fractures and some women with low BMC do not. In these commonly used epidemiologic study designs, BMC does not discriminate between those who have and have not experienced the untoward event at some level of the exposure factor. The ability to discriminate is more properly determined by the sensitivity and specificity of the measured value. To contrast the concepts of risk and sensitivity, a nested case-control study was conducted within a 24-year cohort study of women at risk for osteoporosis. We found that for each 1.0 decrement of BMC z-scores, the adjusted relative risk for the prospective study design was 1.67, while the odds ratio obtained from the most recent BMC z-score measurements was 1.87. A receiver operating characteristic (ROC) curve, calculated from the nested case-control study data, showed that BMC z-scores, measured after low-trauma fracture, have both low sensitivity and low specificity to detect existing fracture status.

UR - http://www.scopus.com/inward/record.url?scp=0026475535&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026475535&partnerID=8YFLogxK

U2 - 10.1007/BF01623185

DO - 10.1007/BF01623185

M3 - Article

VL - 2

SP - 290

EP - 297

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 6

ER -