Selective screening for osteoporosis in younger postmenopausal women

简介（由申请人提供）：候选人：Margaret Gourlay， MD，公共卫生硕士，北卡罗来纳大学家庭医学助理教授。职业发展计划：候选人将参加课程和指导研究，学习骨质疏松研究设计和实施的基本技能，并培养学术领导能力。近期目标：在骨质疏松筛查研究中获得流行病学和密度学概念方面的专业知识。长期目标：通过在初级保健实践中推进绝经后65岁以下妇女骨质疏松症筛查方案的发展，降低老年人骨折相关的发病率和死亡率。具体目的：1)确定现有的两种骨折风险评估方法在年轻绝经后妇女中的准确性；2)确定现有的骨质疏松风险评估工具在年轻绝经后妇女中的准确性；3)检验研究选择性筛查识别年轻绝经后妇女骨质疏松症的可行性。研究方法：在目的1和2中，对美国最大的两项骨质疏松队列研究（NORA， SOF）的数据进行二次分析，比较骨折指数和外周骨密度预测50 - 64岁绝经后妇女骨折的能力，并比较骨质疏松风险工具识别年轻和老年绝经后妇女外周骨质疏松的能力。在目标3中，一项包括中央和外周骨密度测量的可行性研究将为年轻绝经后妇女选择性骨质疏松筛查的R01研究提供初步数据。环境：患者将从3个北卡罗来纳大学初级保健诊所和社区家庭医学诊所招募，目的是在美国国立卫生研究院资助的北卡罗来纳大学普通临床研究中心进行可行性研究。指导：指导将由两位非常成功的nia资助的老龄化研究人员(dr .。斯隆和齐默尔曼)，筛查方法方面的国家专家（Ransohoff博士），骨质疏松症专家(dr。Rubin和Ontjes)，以及一位生物统计专家（Preisser博士）。NORA （Miller博士）和SOF （Ensrud博士）的研究人员将监督目标1和目标2中的分析。相关性：骨质疏松症是一种常见的，可预防的疾病，导致绝经后妇女骨折相关的高发病率和死亡率。本研究将测试65岁以下绝经后妇女骨质疏松症筛查策略，目的是预防骨折。

DESCRIPTION (provided by applicant): Candidate: Margaret Gourlay, MD, MPH is an assistant professor of Family Medicine at the University of North Carolina. Career Development Plan: the candidate will participate in coursework and mentored research to learn essential skills in osteoporosis study design and implementation and to develop academic leadership. Immediate Objective: to acquire expertise in epidemiologic and densitometric concepts in osteoporosis screening research. Long-term Objective: to decrease fracture-related morbidity and mortality in the elderly by advancing the development of an evidence-based osteoporosis screening protocol for postmenopausal women under age 65 in primary care practices. Specific Aims: 1) determine if two existing methods of fracture risk assessment are accurate in younger postmenopausal women, 2) determine if existing osteoporosis risk assessment tools are accurate in younger postmenopausal women, and 3) test the feasibility of a study of selective screening to identify osteoporosis in younger postmenopausal women. Research Methods: in aims 1 and 2, secondary analyses of data from the two largest US osteoporosis cohort studies (NORA, SOF) will compare the ability of a fracture index vs. peripheral bone density to predict fracture in postmenopausal women aged 50 to 64, and will compare the ability of osteoporosis risk tools to identify peripheral osteoporosis in younger vs. older postmenopausal women. In aim 3, a feasibility study that includes central and peripheral bone density measures will provide preliminary data for an R01 study of selective osteoporosis screening in younger postmenopausal women. Environment: patients will be recruited from 3 UNC primary care clinics and community family medicine clinics for the aim 3 feasibility study conducted in the NIH-funded General Clinical Research Center at UNC. Mentorship: mentorship will be provided by two highly successful NIA-funded researchers on aging (Drs. Sloane and Zimmerman), a national expert on screening methodology (Dr. Ransohoff), osteoporosis specialists (Drs. Rubin and Ontjes), and a biostatistical expert (Dr. Preisser). Investigators from NORA (Dr. Miller) and SOF (Dr. Ensrud) will supervise the analyses in aims 1 and 2. Relevance: osteoporosis is a common, preventable condition that leads to high fracture-related morbidity and mortality in postmenopausal women. This study will test osteoporosis screening strategies for postmenopausal women under 65 with the goal of preventing fracture.