Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group,Archives of Osteoporosis

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Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group
Archives of Osteoporosis ( IF 3.1 ) Pub Date : 2022-06-28 , DOI: 10.1007/s11657-022-01117-6
P Chotiyarnwong _{1,

2} , E V McCloskey _{1,

3} , N C Harvey ₄ , M Lorentzon _{5,

6} , D Prieto-Alhambra _{7,

8} , B Abrahamsen _{9,

10} , J D Adachi ₁₁ , F Borgström _{12,

13} , O Bruyere ₁₄ , J J Carey _{15,

16} , P Clark ₁₇ , C Cooper ₄ , E M Curtis ₄ , E Dennison ₄ , M Diaz-Curiel ₁₈ , H P Dimai ₁₉ , D Grigorie _{20,

21} , M Hiligsmann ₂₂ , P Khashayar ₂₃ , E M Lewiecki ₂₄ , P Lips ₂₅ , R S Lorenc ₂₆ , S Ortolani ₂₇ , A Papaioannou _{28,

29} , S Silverman ₃₀ , M Sosa ₃₁ , P Szulc ₃₂ , K A Ward ₄ , N Yoshimura ₃₃ , J A Kanis _{3,

6}

Affiliation

Department of Oncology & Metabolism, Mellanby Centre for Musculoskeletal Research, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK.
Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Centre for Metabolic Bone Diseases, Northern General Hospital, University of Sheffield, Herries Road, Sheffield, S5 7AU, UK.
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
University of Gothenburg, Gothenburg, Sweden.
Australian Catholic University, Melbourne, Australia.
Oxford NIHR Biomedical Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
GREMPAL (Grup de Recerca en Malalties Prevalents de L'Aparell Locomotor) Research Group, CIBERFes and Idiap Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona and Instituto de Salud Carlos III, Gran Via de Les Corts Catalanes, 591 Atico, 08007, Barcelona, Spain.
Department of Clinical Research, Odense Patient Data Exploratory Network, University of Southern Denmark, Odense, Denmark.
Department of Medicine, Holbæk Hospital, Holbæk, Denmark.
Department of Medicine, Michael G DeGroote School of Medicine, St Joseph's Healthcare-McMaster University, Hamilton, ON, Canada.
Quantify Research, Stockholm, Sweden.
Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
School of Medicine, National University of Ireland Galway, Galway, Ireland.
Department of Rheumatology, Galway University Hospitals, Galway, Ireland.
Clinical Epidemiology Unit of Hospital Infantil de México Federico Gómez-Faculty of Medicine, Universidad Nacional Autónoma de México, UNAM, Mexico City, Mexico.
Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
Carol Davila University of Medicine, Bucharest, Romania.
Department of Endocrinology & Bone Metabolism, National Institute of Endocrinology, Bucharest, Romania.
Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
Center for Microsystems Technology, Imec and Ghent University, 9050, Ghent, Belgium.
New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
Department of Internal Medicine, Endocrine Section & Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Multidisciplinary Osteoporosis Forum, SOMED, Warsaw, Poland.
IRCCS Istituto Auxologico, UO Endocrinologia E Malattie del Metabolismo, Milano, Italy.
Department of Medicine, McMaster University, Hamilton, ON, Canada.
GERAS Centre for Aging Research, Hamilton, ON, Canada.
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Bone Metabolic Unit, University of Las Palmas de Gran Canaria, Hospital University Insular, Las Palmas, Gran Canaria, Spain.
INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
Department of Preventive Medicine for Locomotive Organ Disorders, 22Nd Century Medical and Research Center, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.

Summary

The IOF Epidemiology and Quality of Life Working Group has reviewed the potential role of population screening for high hip fracture risk against well-established criteria. The report concludes that such an approach should strongly be considered in many health care systems to reduce the burden of hip fractures.

Introduction

The burden of long-term osteoporosis management falls on primary care in most healthcare systems. However, a wide and stable treatment gap exists in many such settings; most of which appears to be secondary to a lack of awareness of fracture risk. Screening is a public health measure for the purpose of identifying individuals who are likely to benefit from further investigations and/or treatment to reduce the risk of a disease or its complications. The purpose of this report was to review the evidence for a potential screening programme to identify postmenopausal women at increased risk of hip fracture.

Methods

The approach took well-established criteria for the development of a screening program, adapted by the UK National Screening Committee, and sought the opinion of 20 members of the International Osteoporosis Foundation’s Working Group on Epidemiology and Quality of Life as to whether each criterion was met (yes, partial or no). For each criterion, the evidence base was then reviewed and summarized.

Results and Conclusion

The report concludes that evidence supports the proposal that screening for high fracture risk in primary care should strongly be considered for incorporation into many health care systems to reduce the burden of fractures, particularly hip fractures. The key remaining hurdles to overcome are engagement with primary care healthcare professionals, and the implementation of systems that facilitate and maintain the screening program.

中文翻译：

是时候考虑对绝经后女性进行骨折风险人群筛查了吗？国际骨质疏松症基金会流行病学/生活质量工作组的立场文件

概括

IOF 流行病学和生活质量工作组根据既定标准审查了人群筛查髋部骨折高风险的潜在作用。该报告的结论是，许多医疗保健系统应大力考虑采取这种方法，以减轻髋部骨折的负担。

介绍

在大多数医疗保健系统中，长期骨质疏松症管理的负担落在初级保健上。然而，许多此类环境中存在着广泛且稳定的治疗差距；其中大部分似乎是由于缺乏对骨折风险的认识而导致的。筛查是一项公共卫生措施，旨在识别可能受益于进一步检查和/或治疗以降低疾病或其并发症风险的个人。本报告的目的是审查潜在筛查计划的证据，以识别髋部骨折风险增加的绝经后妇女。