Submited on: 29 Jan 2014 02:00:29 AM GMT
Published on: 29 Jan 2014 09:11:12 AM GMT
 

  • What are the main claims of the paper and how important are they?

    The author has investigated the correlation between FRAX risk score and the severity of osteoporotic fracture. The author has also examined the correlation of the FRAX model by investigating whether the model can be the prognostic prediction factor of osteoporotic fracture.

    FRAX model is a diagnostic tool used to predict the 10-year probability of bone fracture risk. The author is extending the use of FRAX to predict the severity of osteoporotic fractures. Because of non-availability of data on BMD in some cases, the results were evaluated in two groups i.e. FRAX with and without BMD, with different results in two groups.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No,

    It can be hypothesized that major risk factors used for calculation of FRAX score to predict the probability of major osteoporotic fractures may also be associated with severity of these fractures but the FRAX tool does not take into account many factors associated with severity of the fractures such as fall severity.

    The results of this study indicate that FRAX score with BMD has a correlation with severity of vertebral fractures while FRAX without inclusion of BMD failed to show any correlation. This is contrary to many studies that claim that FRAX with and without BMD models are of similar worth in measuring major osteoporotic fracture predictions.

    1. Gadam RK, Schlauch K, Izuora KE. Frax Prediction without BMD for Assessment of Osteoporotic Fracture Risk. Endocr Pract. 2013;19(5):780-784.
    2. Premaor M. FRAX with or without BMD predicted fractures in obese, nonobese women. J Bone Miner Res. 2013; 28:188-195.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    There are a few deviations in the set protocol such as calculation of FRAX score with missing details of parental fracture history and severity index of fractures calculated at different vertebrae due to incomplete records, but the author has adequately explained the reasons.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No. It’s a retrospective analysis and as such its shortcoming has been acknowledged by the author.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No. the author has provided a weaker evidence which needs further well designed evaluation studies.


  • Other Comments:

    The author has designed this retrospective study adequately. He has also recognized the limitation of this study and the need for a large scale prospective study to further evaluate the claims.

    The authors has not calculated the appropriate sample size which would have given authenticity to the results of this study.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:

    None

  • Experience and credentials in the specific area of science:

    Head of Obstetrics and Gynecology at a Post Graduate Medical Institute, running a busy menopausal clinic

  • How to cite:  Muhammad A .Review on Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture[Review of the article 'Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture ' by Jung M].WebmedCentral 2014;5(3):WMCRW003025
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Review on Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture
Posted by Prof. Kulvinder K Kaur on 01 Feb 2014 05:59:00 AM GMT Reviewed by Author Invited Reviewers

  • What are the main claims of the paper and how important are they?

    The author has carried a retrospective study to identify the correlation between FRAX risk score and severity of osteoporotic vertebral fractures by studying files of patients from 2002 to 2012in university hospital korea  and identifying 214 inpatients who had osteoporotic vertebral  fractures after excluding exclusion criteria like past H/O major fracture,vertebral surgery /suspected vertebral metastasis out of total 419 patients.Further they subdivided into 2 groups according to BMD score present /-nt(BMD/non BMD group)and calculated fracture severity index from lateral vertebral xray film with Genants semiquantitative methodand analyzed the correlation between FRAX risk score and fracture severity index.Although they found a  ststisticallly significant correlation between FRAX risk score (major osteoporotic and hip fracture)as well as fracture severity index in the BMD group as well as between FRAX risk score and BMD ,they did not find any correlation in the non BMD group  unlike some other groups who found a statistically significant correlation even in non BMD group.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No

    1. Olmez Sakariya N,Kapar Yavasi S,Tan G,Satiroglu S,Yidiz AH,Oz B,Yoleri O,Memis A.Agreement beterrn FRAX scores calculated with and without bone mineral density in women with osteopenia in Turkey.Clin Rheumatol 2014 jan 29 epub ahead of print.
    2. Hagino H.New development in osteoporosis treatment .Revised osteoporosisdiagnostic criteria and japanese practice guideline on osteoporosis.Clin Calcium 2014;24(1):11-8.
    3. McCloskey E.Assessing fracture risk in p[atients with osteoporosis.Practitioner 2013;257(1765):19-21,2-3.
    4.Strugala C,Sobala W,Szubert Z,Hanke W.Evaluation of osteoporotic fractures in the grioup of women over 50 years of age-comparison of tools FRAX BMD versus FRAX BMI.Med Pr 2013;64(3):327-33.
    5. Beattie KA,Ioannidis G,Macdermid JC,Grewal R,Papaioannou A,Adachi JD,Hodsman AB.Appropriate osteoporosis treatment by family physician in response to FRAX vs CAROC Reporting :rESULTS FROM A RANDOMIZED CONTROLLED TRIAL.J Clin Densitom 2013 oct 24 epub ahead of print.
    6. Gadam RK,Schlauch K,Izuora KE.FRAX Prediction without BMD for assessment of osteoporitic fracture risk.Endocr Pract 2013;19(5):780-784.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    This is a retrospective study and author has explained limitations of the study and proposes a prospective trial  and the further studies required to see how much is the contribution of FRAX risk scores in as a prediction factor for severity of fractures  and how much each factor may contribute as a risk factor in the presence of preexisting fractures  and the bias of the selection groups and fracture sites selected not being uniform.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes the lacunae of the study are highlighted by author himself  and proposes a future prospective study.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No to obviate the lacunae a further prospective study required otherwise with the available data the author has properly used inclusion exclusion criteria and statistical back up is there.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No-The vlacunae are highlighted by author himself  regarding bias and why they nay be getting a contrasictory result from that of Gadam RK where they find risk prediction without BMD as good as with BMD AND HOW A PROSPECTIVE STUDY MAY THROW LIGHT ON TO CONTRIBUTION OF EWACH VARIABLE LIKE AGE,HEIGHT,bmi,SMOKING,ALCOHOL INTAKE previous paternal fracture history etc.


  • Other Comments:

    The author has used Genants semi quantitative method to assess the severity of fracture  and even other authors like Nayal et al prefer semiquantitative which is easy to replicate than rhe other methods.

     

    The author has not taken into account the affect of any treatment taken by patients which may affect these scores and in future prospective study it should be taken into account .

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:

    None

  • Experience and credentials in the specific area of science:

    I have been managing postmenpausal women over last 30yrs under the heading gynaecological neuroendocrinilogy and deal with all sorts of old postmenpausal women with any kind of endocrine problems.

  • How to cite:  Kaur K K.Review on Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture[Review of the article 'Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture ' by Jung M].WebmedCentral 2014;5(2):WMCRW002941
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Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture
Posted by Prof. Tae-Hee Kim on 30 Jan 2014 01:22:46 AM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    Yes


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    No


  • Do the results support the claims? If not, what other evidence is required?

    No


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes


  • Other Comments:

    No

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Evaluation of the Osteoporosis Health Belief Scale in Korean Women J Bone Metab 2013;20:25-30

  • Experience and credentials in the specific area of science:

    I Won the prize about the ASBMR award in korea about

  • How to cite:  Kim T .Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture [Review of the article 'Correlation of FRAX Risk Score and Severity in Osteoporotic Vertebral Fracture ' by Jung M].WebmedCentral 2014;5(1):WMCRW002925
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