Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis.

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Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis.
Kvien, Tore Kristian; Haugeberg, Glenn; Uhlig, Till; Falch, J A; Halse, J I; Lems, W F; Dijkmans, B A; Woolf, A D
Annals of the rheumatic diseases 2000, 59 (10):805-11

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dc.contributor.authorKvien, Tore Kristianen
dc.contributor.authorHaugeberg, Glennen
dc.contributor.authorUhlig, Tillen
dc.contributor.authorFalch, J Aen
dc.contributor.authorHalse, J Ien
dc.contributor.authorLems, W Fen
dc.contributor.authorDijkmans, B Aen
dc.contributor.authorWoolf, A Den
dc.identifier.citationAnnals of the rheumatic diseases 2000, 59 (10):805-11en
dc.description.abstractTo examine relations between osteoporosis and low bone mass and demographic and clinical variables in patients with rheumatoid arthritis (RA), in an attempt to develop a data driven clinical tool for identification of patients at high risk of osteoporosis.en
dc.description.abstractAll patients were recruited from a county based register and were examined cross sectionally with a variety of clinical and health status measures as well as bone density measures (anteroposterior spine L2-4, total hip, and femoral neck). Associations between osteoporosis (T score < or = -2.5SD) and low bone mass (T score < or = -1SD), on the one hand, and demographic and clinical measures, on the other, were examined bivariately and by logistic regression analyses.en
dc.description.abstract394 patients with a mean age of 54.8 years were examined. The percentages having osteoporosis/low bone mass were 16.8/45.8, 14.7/54.5 and 14.7/55.5 in spine L2-4, total hip, and femoral neck, respectively. Osteoporosis and low bone mass were bivariately related to age, body mass index (BMI), disease duration, disease process measures, presence of deformed joints, physical disability, current use of corticosteroids, and history of non-vertebral fracture. In multivariate analyses, age >60 years, low BMI, and current use of corticosteroids were consistently related to osteoporosis and to low bone mass at all sites. The presence of deformed joints was associated with osteoporosis at the total hip, and a history of previous non-vertebral fracture with osteoporosis at the femoral neck. The Modified Health Assessment Questionnaire (MHAQ) > or = 1.5 and non-vertebral fracture were also independently associated with low bone mass at the hip. The logistic regression analyses models could, however, only predict osteoporosis with a sensitivity of about 50-60% and a specificity of 80-90% at the various measurement sites, and low bone mass with a sensitivity and specificity of about 70%.en
dc.description.abstractConsideration of demographic and disease markers may be of some help in predicting presence of osteoporosis or low bone mass, but a combination of markers cannot be used as a clinical tool with sufficient sensitivity and specificity for the identification of osteoporosis or low bone mass in patients with RA.en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Reumatologi: 759en
dc.subject.meshActivities of Daily Livingen
dc.subject.meshAge Factorsen
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshBody Mass Indexen
dc.subject.meshBone Densityen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshMiddle Ageden
dc.subject.meshPredictive Value of Testsen
dc.subject.meshRegression Analysisen
dc.subject.meshRisk Factorsen
dc.subject.meshSensitivity and Specificityen
dc.subject.meshSeverity of Illness Indexen
dc.titleData driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentDepartment of Rheumatology, Diakonhjemmet Hospital, PB 23 Vinderen, 0319 Oslo, Norway.en
dc.identifier.journalAnnals of the rheumatic diseasesen

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