New Tools Predict Patient Risk for Diabetes, Osteoporotic Fractures
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In separate articles, researchers describe a new patient self-assessment diabetes screening score and two new algorithms for predicting a person’s 10-year risk for osteoporotic or hip fracture.
Bang and colleagues developed a new screening score for undiagnosed diabetes in multiethnic U.S. adults using recent data from multiple years of the National Health and Nutrition Examination Survey (NHANES). The screening score enables laypersons to assess their own risk for undiagnosed diabetes by answering simple questions about age, sex, family history of diabetes, personal history of high blood pressure, obesity, and physical activity. The new score seemed to perform better than existing diabetes screening guidelines from the Centers for Disease Control and Prevention, American Diabetes Association, and U.S. Preventive Services Task Force, as well as two American Diabetes Association risk-scoring algorithms (the “ADA diabetes questionnaires”). Complete study results and a sample questionnaire that incorporates the screening score can be found in the December 1, 2009, issue of Annals of Internal Medicine.
Hippisley-Cox and Coupland used data from more than 2 million men and women in the United Kingdom to develop QFractureScores, algorithms for estimating the individual risk of osteoporotic fracture or hip fracture over 10 years. The algorithms are based on variables that usually are readily available in patients’ medical records or that patients themselves are likely to know, obviating the need for laboratory tests or clinical measurements. The researchers reported some evidence of improved discrimination and calibration compared with the FRAX (fracture risk assessment) algorithm. The study results were reported in the November 19, 2009, Online First issue of British Medical Journal; a Web-based calculator is available at www.qfracture.org.
Ann Intern Med. 2009;151:775-783.
Br Med J. 2009;339:b4229.