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Combining Imaging and Modeling in Osteoporosis Fracture Risk Assessment

结合成像和建模进行骨质疏松症骨折风险评估

基本信息

批准号：
9062400
负责人：
Gary Beaupre
金额：
--
依托单位：
VETERANS ADMIN PALO ALTO HEALTH CARE SYS
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-10-01 至 2012-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9062400
关键词：
Activities of Daily Living Adult Affect Age Aging American Bone Density Cadaver Clinic Clinical Clinical Research Colles&apos Fracture Computational Technique Data Databases Densitometry Development Devices Diagnosis Disadvantaged Disease Disease Progression Distal Drug Prescriptions Dual-Energy X-Ray Absorptiometry Elderly Engineering Epidemiologic Studies Female Femur Financial cost Forearm Fosamax Foundations Fracture Future Generic Drugs Goals Health Health Policy High Resolution Computed Tomography Hip Fractures Hip region structure Image Image Analysis Individual Intervention Lead Legal patent Life Style Link Measurement Measures Methods Modeling Morbidity - disease rate Names Osteopenia Osteoporosis Patients Peripheral Pharmaceutical Preparations Physicians&apos Offices Play Postmenopause Prevalence Primary Care Physician Quality-Adjusted Life Years Radial Research Research Personnel Resolution Risk Risk Assessment Risk Estimate Roentgen Rays Role Scanning Scientist Sentinel Site Societies Spinal Fractures Techniques Technology Testing Time Tomography, Computed, Scanners Translating Vertebral column Veterans Woman World Health Organization Wrist X-Ray Computed Tomography abstracting analytical tool base bone bone imaging bone mass bone strength clinical application clinically relevant computerized data processing computerized tools cost demographics epidemiology study experience improved in vivo male men mortality portability prognostic value research study skeletal statistics tool wrist fracture young adult

项目摘要

DESCRIPTION (provided by applicant): 6. Project Summary/Abstract Osteoporosis is a major and growing US heath concern. The National Osteoporosis Foundation estimates that 44 million Americans have osteoporosis or low bone mass. For many of these individuals a fragility fracture will be the first indication that they have the disease. These fractures are associated with morbidity, limitations in the activities of daily living, increased mortality, particularly in the case of hip fractures, and a financial cost to society that is estimated at $19 billion per year or more than $52 million per day. Although osteoporosis is perceived by many as a disease primarily affecting post-menopausal females, it has recently been estimated that one out of eight older male veterans has osteoporosis. This translates to a prevalence of nearly 1.2 million male veterans with osteoporosis. Based on fracture statistics and veterans demographics (more than 12 male veterans for every female veteran), approximately three times as many male veterans as female veterans are expected to experience a fragility fracture. Given these facts we believe the VA has an important responsibility to be a leading stakeholder in osteoporosis research, especially given the number of male veterans likely to experience an osteoporosis-related fractures. The most common method for osteoporosis assessment uses an X-ray based technique called Dual- energy X-ray Absorptiometry, or DXA for short. The default DXA measurements were originally proposed for use in large epidemiology studies and were not intended to be used for diagnosis or treatment of individual patients. Nevertheless, these DXA measures are routinely used by primary care physicians in osteoporosis diagnosis and treatment even though these DXA measures are not accurate predictors of bone strength or fracture risk in an individual patient. The goal of this project is to develop more accurate approaches for estimating bone strength using newly developed engineering-based techniques. The project will examine three X-ray based technologies currently used for osteoporosis assessment. For each of these technologies we will quantify the accuracy with which they can predict the experimentally measured strength of cadaver bones from 25 male and 25 female donors. For each technology we will first assess the accuracy of estimating bone strength using the default measures available for that technology. We will then used new analytical and computational tools that we have developed that we believe will result in substantial improvements in estimating bone strength and that can be used in future clinical and research studies to more accurately predict bone strength in vivo. The specific densitometry technologies to be assessed were chosen so that the results will have the broadest possible impact for clinicians, clinician scientists and researchers. The ultimate goal of this research is to provide additional and better ways to identify individuals with low bone strength who would benefit from pharmacological interventions or lifestyle changes, thereby reducing both the near-term and long-term risks and costs of osteoporosis-related fractures.

描述（由申请人提供）： 6.项目摘要/摘要骨质疏松症是一个主要的和日益增长的美国健康问题。国家骨质疏松基金会估计，4400万美国人患有骨质疏松症或低骨量。对于这些人中的许多人来说，脆性骨折将是他们患有这种疾病的第一个迹象。这些骨折与发病率、日常生活活动受限、死亡率增加（特别是在髋部骨折的情况下）以及估计为每年190亿美元或每天超过5200万美元的社会财务成本相关。虽然骨质疏松症被许多人认为是一种主要影响绝经后女性的疾病，但最近估计，每八名老年男性退伍军人中就有一名患有骨质疏松症。这意味着近120万男性退伍军人患有骨质疏松症。根据骨折统计数据和退伍军人人口统计数据（每名女性退伍军人超过12名男性退伍军人），预计男性退伍军人中发生脆性骨折的人数约为女性退伍军人的三倍。鉴于这些事实，我们认为退伍军人事务部有一个重要的责任，是骨质疏松症研究的主要利益相关者，特别是考虑到男性退伍军人的数量可能会经历骨质疏松症相关的骨折。骨质疏松症评估的最常见方法是使用基于X射线的技术，称为双能X射线吸收测定法，简称DXA。默认DXA测量最初建议用于大型流行病学研究，而不是用于诊断或治疗个体患者。尽管如此，这些DXA测量通常由初级保健医生用于骨质疏松症的诊断和治疗，即使这些DXA测量不是个体患者骨强度或骨折风险的准确预测因子。该项目的目标是开发更准确的方法来估计骨强度使用新开发的工程为基础的技术。该项目将检查目前用于骨质疏松症评估的三种基于X射线的技术。对于这些技术中的每一种，我们将量化它们可以预测来自25名男性和25名女性捐赠者的尸体骨骼的实验测量强度的准确性。对于每种技术，我们将首先评估使用该技术可用的默认测量值估计骨强度的准确性。然后，我们将使用我们开发的新的分析和计算工具，我们相信这些工具将大大改善骨强度的估计，并可用于未来的临床和研究，以更准确地预测体内骨强度。选择待评估的特定密度测定技术，以便结果对临床医生、临床科学家和研究人员产生尽可能广泛的影响。这项研究的最终目标是提供额外的和更好的方法来识别骨强度低的个体，这些个体将从药物干预或生活方式改变中受益，从而降低骨关节炎相关骨折的近期和长期风险和成本。