围绕确定10年绝对骨折风险的BMD报告标准的争议:加拿大视角

Kerry Siminoski, Margaret O'Keeffe, Cigdem Akincioglu, S Nimu Ganguli, Jacques Levesque, Peter Raaphorst, Giuseppe Tarulli, Wendy Thurston, David Lyons
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引用次数: 0

摘要

加拿大放射科医师协会和加拿大骨质疏松症协会目前认可一种名为CAROC的骨折风险预测工具。自2005年以来,它一直在加拿大使用,2010年进行了更新。它是全国骨矿物质密度报告的一个组成部分。加拿大骨质疏松症(OC)的新骨质疏松指南预计将在不久的将来发布。放射科医生面临着使用FRAX替代骨折风险预测平台报告骨折风险的压力。此外,OC还参与了加拿大FRAX模型的开发,并一直在共同推广FRAX和CAROC,这使得新的指导方针可能会寻求用FRAX取代CAROC来确定压裂风险。人们对FRAX提出了一些担忧,包括:(1)FRAX尚未将其算法发布到公共领域,其结果是无法验证单个患者的结果;(2) FRAX错误地声称它是由世界卫生组织(世卫组织)开发的,并利用这种关系来宣传自己,直到最近世卫组织下令停止;(3) FRAX需要收集CAROC所需的额外临床信息,并且这种患者报告的医疗数据容易出现重大错误;(4)尽管有相反的说法,但没有有效的研究将FRAX与CAROC进行比较。我们认为,放射科医生意识到这些问题是很重要的,以便为加拿大放射科医师协会未来的骨矿物质密度报告技术标准提供投入。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Controversies Surrounding the BMD Reporting Standard for the Determination of 10-Year Absolute Fracture Risk: A Canadian Perspective.

The Canadian Association of Radiologists and Osteoporosis Canada currently endorse a fracture risk prediction tool called CAROC. It has been used in Canada since 2005 with an update in 2010. It is an integral part of bone mineral densitometry reporting across the country. New osteoporosis guidelines from Osteoporosis Canada (OC) are expected in the near future. There has been pressure on radiologists to report fracture risk using an alternative fracture risk prediction platform called FRAX. In addition, OC collaborated in the development of the Canadian FRAX model and has been copromoting both FRAX and CAROC, raising the prospect that new guidelines may seek to replace CAROC with FRAX for fracture risk determination. A number of concerns have been raised about FRAX, including: (1) FRAX has not released its algorithms to the public domain with the consequence that it is impossible to verify results for an individual patient; (2) FRAX has incorrectly claimed that it was developed by the World Health Organization (WHO) and has used this affiliation to promote itself until recently ordered by the WHO to desist; (3) FRAX requires collection of additional clinical information beyond that needed for CAROC, and this patient-reported medical data is prone to substantial error; and (4) despite claims to the contrary, there are no valid studies comparing FRAX to CAROC. We believe it is important that radiologists be aware of these issues in order to provide input into future Technical Standards for Bone Mineral Densitometry Reporting of the Canadian Association of Radiologists.

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