Comparison of the effectiveness of different approaches to osteoporosis diagnosis organizing and identification of patients at high fracture risk in the Russian population

Gladkova E.N.; Lesnyak O.M.; Ershova O.B.; Skripnikova I.A.; Anoshenkova O.N.; Ahverdyan Yu.R.; Belova K.Yu.; Belousova I.B.; Bol’shakova E.V.; Grebenkina M.V.; Dreval A.V.; Zavodovsky B.V.; Zotkina K.E.; Il’in M.V.; Kasimova A.M.; Kolchinskij I.A.; Kosmatova O.V.; Kryukova I.V.; Ahatov A.F.; Latfullin A.A.; Lejkauskene E.A.; Leonova N.V.; Maksimova Yu.V.; Myagkova M.A.; Novikov V.E.; Polyakova E.Yu.; Polyakova Yu.V.; Sivordova L.E.; Tavluev V.A.

doi:https://doi.org/10.17116/profmed20212410114

Gladkova E.N.

Mechnikov North-Western State Medical University

Lesnyak O.M.

Mechnikov North-Western State Medical University

Ershova O.B.

Yaroslavl State Medical University

Skripnikova I.A.

National Medical Research Center for Therapy and Preventive Medicine

Anoshenkova O.N.

OOO Max & K — Medical Care Center «Maximum Health»;
Siberian State Medical University

Ahverdyan Yu.R.

A.B. Zborovsky Research Institute of Clinical and Experimental Rheumatology

Belova K.Yu.

Yaroslavl State Medical University;
Solovyov Clinical Hospital for Emergency Care

Belousova I.B.

Clinical Hospital No. 101 — Branch of the North Caucasus Federal Research and Clinical Center

Bol’shakova E.V.

Yaroslavl State Medical University

Grebenkina M.V.

North-Western State Medical University named after I. I. Mechnikov

Dreval A.V.

Moscow Regional Research and Clinical Institute («MONIKI»)

Zavodovsky B.V.

Volgograd State Medical University;
Zborovsky Research Institute of Clinical and Experimental Rheumatology

Zotkina K.E.

Clinical Rheumatology Hospital No. 25

SPIN RSCI: 3494-9650
Scopus AuthorID: 57226492629
ORCID: 0000-0002-8188-1289

Il’in M.V.

Yaroslavl State Medical University

Kasimova A.M.

North-Western State Medical University named after I. I. Mechnikov

Kolchinskij I.A.

North-Western State Medical University named after I. I. Mechnikov

Kosmatova O.V.

National Medical Research Center for Therapy and Preventive Medicine Federal State Budgetary Institution the Ministry of Health of Russia

Kryukova I.V.

Moscow Regional Research and Clinical Institute («MONIKI»)

Ahatov A.F.

OOO BARSMED

Latfullin A.A.

OOO BARSMED

Lejkauskene E.A.

OOO Medical Multidisciplinary Clinic «Anturium»

Leonova N.V.

OOO Medical Multidisciplinary Clinic «Anturium»

Maksimova Yu.V.

OOO Max & K — Medical Care Center «Maximum Health»

Myagkova M.A.

National Medical Research Center for Therapy and Preventive Medicine

Novikov V.E.

National Medical Research Center for Therapy and Preventive Medicine

Polyakova E.Yu.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

Polyakova Yu.V.

Petrovsky National Research Centre of Surgery, Ministry of Education and Science of Russia

Sivordova L.E.

A.B. Zborovsky Research Institute of Clinical and Experimental Rheumatology

Tavluev V.A.

OOO Max & K — Medical Care Center «Maximum Health»

Comparison of the effectiveness of different approaches to osteoporosis diagnosis organizing and identification of patients at high fracture risk in the Russian population

Authors:

Gladkova E.N., Lesnyak O.M., Ershova O.B., Skripnikova I.A., Anoshenkova O.N., Ahverdyan Yu.R., Belova K.Yu., Belousova I.B., Bol’shakova E.V., Grebenkina M.V., Dreval A.V., Zavodovsky B.V., Zotkina K.E., Il’in M.V., Kasimova A.M., Kolchinskij I.A., Kosmatova O.V., Kryukova I.V., Ahatov A.F., Latfullin A.A., Lejkauskene E.A., Leonova N.V., Maksimova Yu.V., Myagkova M.A., Novikov V.E., Polyakova E.Yu., Polyakova Yu.V., Sivordova L.E., Tavluev V.A.

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Journal: Russian Journal of Preventive Medicine. 2021;24(10): 14‑23

DOI: 10.17116/profmed20212410114

Read: 1381 times

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To cite this article:

Gladkova EN, Lesnyak OM, Ershova OB, et al. . Comparison of the effectiveness of different approaches to osteoporosis diagnosis organizing and identification of patients at high fracture risk in the Russian population. Russian Journal of Preventive Medicine. 2021;24(10):14‑23. (In Russ.)
https://doi.org/10.17116/profmed20212410114

Подписка 2026 Профилактическая медицина (Russian Journal of Preventive Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

Comparative evaluation of the clinical and commercial effectiveness of two approaches to identifying patients at high fracture risk using the International Society for Clinical Densitometry (ISCD) indications for DXA densitometry, and the FRAX 10-year fracture risk calculation.

MATERIALS AND METHODS

A multicenter, single-center study was conducted in a cohort of residents of 6 cities of the Russian Federation, including 4042 postmenopausal women aged 40 years and older who were not receiving bone-sparing agents. Two approaches to identifying patients at high risk of fracture were analyzed: referral of patients for densitometry based on the 2019 ISCD recommendations and identification of patients at high fracture risk based on a 10-year fracture risk calculation using the FRAX algorithm. Test methods diagnostic value parameters: sensitivity, specificity, and accuracy, as well as the cost of identifying one patient at high fracture risk, were evaluated.

RESULTS

Search strategy for patients at high fracture risk based on the ISCD recommendations led to an unreasonably high number of densitometric studies and increased diagnostic costs. The FRAX algorithm helped identify more patients at high fracture risk with optimal use of the DXA resource. When comparing the proportion of subjects who needed diagnostic densitometry, the rates were 71.4% and 54.0% for ISCD and FRAX, respectively (p=0.0001). The sensitivity of mFRAX in detecting osteoporosis by densitometry was 86.3%, while the ISCD guidelines were 85.1% (p=0.07). The FRAX method demonstrated higher specificity (43.4 and 31.9%, respectively; p=0.002) and precision (55.4 and 42.2%, respectively; p=0.001). FRAX method reduced the cost per high fracture risk diagnosis by a factor of 1.9 compared to ISCD guidelines.

CONCLUSION

Thus, FRAX proved to be a more effective method of identifying patients at high fracture risk. With sensitivity comparable to the ISCD guidelines, FRAX has higher specificity and precision, resulting in minimized costs for diagnosing high fracture risk.

Keywords:

osteoporosis

diagnostic threshold

risk assessment

densitometry

FRAX

ISCD

Authors:

Gladkova E.N.

Mechnikov North-Western State Medical University

Lesnyak O.M.

Mechnikov North-Western State Medical University

Ershova O.B.

Yaroslavl State Medical University

Skripnikova I.A.

National Medical Research Center for Therapy and Preventive Medicine

Anoshenkova O.N.

OOO Max & K — Medical Care Center «Maximum Health»;
Siberian State Medical University

Ahverdyan Yu.R.

A.B. Zborovsky Research Institute of Clinical and Experimental Rheumatology

Belova K.Yu.

Yaroslavl State Medical University;
Solovyov Clinical Hospital for Emergency Care

Belousova I.B.

Clinical Hospital No. 101 — Branch of the North Caucasus Federal Research and Clinical Center

Bol’shakova E.V.

Yaroslavl State Medical University

Grebenkina M.V.

North-Western State Medical University named after I. I. Mechnikov

Dreval A.V.

Moscow Regional Research and Clinical Institute («MONIKI»)

Zavodovsky B.V.

Volgograd State Medical University;
Zborovsky Research Institute of Clinical and Experimental Rheumatology

Zotkina K.E.

Clinical Rheumatology Hospital No. 25

SPIN RSCI: 3494-9650
Scopus AuthorID: 57226492629
ORCID: 0000-0002-8188-1289

Il’in M.V.

Yaroslavl State Medical University

Kasimova A.M.

North-Western State Medical University named after I. I. Mechnikov

Kolchinskij I.A.

North-Western State Medical University named after I. I. Mechnikov

Kosmatova O.V.

National Medical Research Center for Therapy and Preventive Medicine Federal State Budgetary Institution the Ministry of Health of Russia

Kryukova I.V.

Moscow Regional Research and Clinical Institute («MONIKI»)

Ahatov A.F.

OOO BARSMED

Latfullin A.A.

OOO BARSMED

Lejkauskene E.A.

OOO Medical Multidisciplinary Clinic «Anturium»

Leonova N.V.

OOO Medical Multidisciplinary Clinic «Anturium»

Maksimova Yu.V.

OOO Max & K — Medical Care Center «Maximum Health»

Myagkova M.A.

National Medical Research Center for Therapy and Preventive Medicine

Novikov V.E.

National Medical Research Center for Therapy and Preventive Medicine

Polyakova E.Yu.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

Polyakova Yu.V.

Petrovsky National Research Centre of Surgery, Ministry of Education and Science of Russia

Sivordova L.E.

A.B. Zborovsky Research Institute of Clinical and Experimental Rheumatology

Tavluev V.A.

OOO Max & K — Medical Care Center «Maximum Health»

Received:

27.04.2021

Accepted:

08.07.2021

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References:

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