Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study
© 2020, International Osteoporosis Foundation and National Osteoporosis Foundation. Summary: A reduction in hip fracture incidence following population screening might reflect the effectiveness of anti-osteoporosis therapy, behaviour change to reduce falls, or both. This post hoc analysis demonstrat...
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th-mahidol.538852020-03-26T12:09:41Z Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study C. I. Condurache S. Chiu P. Chotiyarnwong H. Johansson L. Shepstone E. Lenaghan C. Cooper S. Clarke R. F.S. Khioe R. Fordham N. Gittoes I. Harvey N. C. Harvey A. Heawood R. Holland A. Howe J. A. Kanis T. Marshall T. W. O’Neill T. J. Peters N. M. Redmond D. Torgerson D. Turner E. McCloskey N. Crabtree H. Duffy J. Parle F. Rashid K. Stant K. Taylor C. Thomas E. Knox C. Tenneson H. Williams D. Adams V. Bion J. Blacklock T. Dyer S. Bratherton M. Fidler K. Knight C. McGurk K. Smith S. Young K. Collins J. Cushnaghan C. Arundel K. Bell L. Clark S. Collins S. Gardner N. Mitchell Manchester University NHS Foundation Trust Göteborg University, Sahlgrenska Academy University of Oxford MRC Lifecourse Epidemiology Unit University of Bristol Leicester Medical School Norfolk and Norwich University Hospital NHS Trust University of York University of Bristol, Faculty of Medicine and Dentistry Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust University of East Anglia, Faculty of Medicine and Health Sciences Faculty of Medicine, Siriraj Hospital, Mahidol University Australian Catholic University University of Sheffield, School of Medicine and Biomedical Sciences University of Manchester University of Sheffield University Hospital Southampton NHS Foundation Trust Medicine © 2020, International Osteoporosis Foundation and National Osteoporosis Foundation. Summary: A reduction in hip fracture incidence following population screening might reflect the effectiveness of anti-osteoporosis therapy, behaviour change to reduce falls, or both. This post hoc analysis demonstrates that identifying high hip fracture risk by FRAX was not associated with any alteration in falls risk. Introduction: To investigate whether effectiveness of an osteoporosis screening programme to reduce hip fractures was mediated by modification of falls risk in the screening arm. Methods: The SCOOP study recruited 12,483 women aged 70–85 years, individually randomised to a control (n = 6250) or screening (n = 6233) arm; in the latter, osteoporosis treatment was recommended to women at high risk of hip fracture, while the control arm received usual care. Falls were captured by self-reported questionnaire. We determined the influence of baseline risk factors on future falls, and then examined for differences in falls risk between the randomisation groups, particularly in those at high fracture risk. Results: Women sustaining one or more falls were slightly older at baseline than those remaining falls free during follow-up (mean difference 0.70 years, 95%CI 0.55–0.85, p < 0.001). A higher FRAX 10-year probability of hip fracture was associated with increased likelihood of falling, with fall risk increasing by 1–2% for every 1% increase in hip fracture probability. However, falls risk factors were well balanced between the study arms and, importantly, there was no evidence of a difference in falls occurrence. In particular, there was no evidence of interaction (p = 0.18) between baseline FRAX hip fracture probabilities and falls risk in the two arms, consistent with no impact of screening on falls in women informed to be at high risk of hip fracture. Conclusion: Effectiveness of screening for high FRAX hip fracture probability to reduce hip fracture risk was not mediated by a reduction in falls. 2020-03-26T05:09:41Z 2020-03-26T05:09:41Z 2020-01-01 Article Osteoporosis International. (2020) 10.1007/s00198-019-05270-6 14332965 0937941X 2-s2.0-85078312601 https://repository.li.mahidol.ac.th/handle/123456789/53885 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85078312601&origin=inward |
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Medicine C. I. Condurache S. Chiu P. Chotiyarnwong H. Johansson L. Shepstone E. Lenaghan C. Cooper S. Clarke R. F.S. Khioe R. Fordham N. Gittoes I. Harvey N. C. Harvey A. Heawood R. Holland A. Howe J. A. Kanis T. Marshall T. W. O’Neill T. J. Peters N. M. Redmond D. Torgerson D. Turner E. McCloskey N. Crabtree H. Duffy J. Parle F. Rashid K. Stant K. Taylor C. Thomas E. Knox C. Tenneson H. Williams D. Adams V. Bion J. Blacklock T. Dyer S. Bratherton M. Fidler K. Knight C. McGurk K. Smith S. Young K. Collins J. Cushnaghan C. Arundel K. Bell L. Clark S. Collins S. Gardner N. Mitchell Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
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© 2020, International Osteoporosis Foundation and National Osteoporosis Foundation. Summary: A reduction in hip fracture incidence following population screening might reflect the effectiveness of anti-osteoporosis therapy, behaviour change to reduce falls, or both. This post hoc analysis demonstrates that identifying high hip fracture risk by FRAX was not associated with any alteration in falls risk. Introduction: To investigate whether effectiveness of an osteoporosis screening programme to reduce hip fractures was mediated by modification of falls risk in the screening arm. Methods: The SCOOP study recruited 12,483 women aged 70–85 years, individually randomised to a control (n = 6250) or screening (n = 6233) arm; in the latter, osteoporosis treatment was recommended to women at high risk of hip fracture, while the control arm received usual care. Falls were captured by self-reported questionnaire. We determined the influence of baseline risk factors on future falls, and then examined for differences in falls risk between the randomisation groups, particularly in those at high fracture risk. Results: Women sustaining one or more falls were slightly older at baseline than those remaining falls free during follow-up (mean difference 0.70 years, 95%CI 0.55–0.85, p < 0.001). A higher FRAX 10-year probability of hip fracture was associated with increased likelihood of falling, with fall risk increasing by 1–2% for every 1% increase in hip fracture probability. However, falls risk factors were well balanced between the study arms and, importantly, there was no evidence of a difference in falls occurrence. In particular, there was no evidence of interaction (p = 0.18) between baseline FRAX hip fracture probabilities and falls risk in the two arms, consistent with no impact of screening on falls in women informed to be at high risk of hip fracture. Conclusion: Effectiveness of screening for high FRAX hip fracture probability to reduce hip fracture risk was not mediated by a reduction in falls. |
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Manchester University NHS Foundation Trust |
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Manchester University NHS Foundation Trust C. I. Condurache S. Chiu P. Chotiyarnwong H. Johansson L. Shepstone E. Lenaghan C. Cooper S. Clarke R. F.S. Khioe R. Fordham N. Gittoes I. Harvey N. C. Harvey A. Heawood R. Holland A. Howe J. A. Kanis T. Marshall T. W. O’Neill T. J. Peters N. M. Redmond D. Torgerson D. Turner E. McCloskey N. Crabtree H. Duffy J. Parle F. Rashid K. Stant K. Taylor C. Thomas E. Knox C. Tenneson H. Williams D. Adams V. Bion J. Blacklock T. Dyer S. Bratherton M. Fidler K. Knight C. McGurk K. Smith S. Young K. Collins J. Cushnaghan C. Arundel K. Bell L. Clark S. Collins S. Gardner N. Mitchell |
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Article |
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C. I. Condurache S. Chiu P. Chotiyarnwong H. Johansson L. Shepstone E. Lenaghan C. Cooper S. Clarke R. F.S. Khioe R. Fordham N. Gittoes I. Harvey N. C. Harvey A. Heawood R. Holland A. Howe J. A. Kanis T. Marshall T. W. O’Neill T. J. Peters N. M. Redmond D. Torgerson D. Turner E. McCloskey N. Crabtree H. Duffy J. Parle F. Rashid K. Stant K. Taylor C. Thomas E. Knox C. Tenneson H. Williams D. Adams V. Bion J. Blacklock T. Dyer S. Bratherton M. Fidler K. Knight C. McGurk K. Smith S. Young K. Collins J. Cushnaghan C. Arundel K. Bell L. Clark S. Collins S. Gardner N. Mitchell |
author_sort |
C. I. Condurache |
title |
Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
title_short |
Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
title_full |
Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
title_fullStr |
Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
title_full_unstemmed |
Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study |
title_sort |
screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the scoop study |
publishDate |
2020 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/53885 |
_version_ |
1763487579173289984 |