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Developing novel prognostic biomarkers for multivariate fracture risk prediction algorithms

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dc.contributor.author Poku, E.K.
dc.contributor.author Towler, M.R.
dc.contributor.author Cummins, Niamh M.
dc.contributor.author Newman, J.D.
dc.date.accessioned 2013-02-25T16:45:15Z
dc.date.available 2013-02-25T16:45:15Z
dc.date.issued 2012
dc.identifier.uri http://hdl.handle.net/10344/2917
dc.description peer-reviewed en_US
dc.description.abstract Multivariate prediction algorithms such as FRAX® and QFractureScores provide an opportunity for new prognostic biomarkers to be developed and incorporated, potentially leading to better fracture prediction. As more research is conducted into these novel biomarkers, a number of factors need to be considered for their successful development for inclusion in these algorithms. This review paper describes two well-known multivariate prediction algorithms for osteoporosis fracture risk applicable to the UK population, FRAX and QFractureScores, and comments on the current prognostic tools available for fracture risk, dual x-ray assessment (DXA), quantitative ultrasound (QUS), genomic and biochemical markers and highlights the factors that need to be considered in the development of new biomarkers. These factors include the requirement for prospective data, collected in new cohort studies or using archived samples, the need for adequate stability data to be provided and appropriate storage methods to be used when retrospective data is required. AUC measures have been found to have limited utility in assessing the impact of the addition of new risk factors on the predictive performance multivariate algorithms. New performance evaluation measures, such as net reclassification index (NRI) and integrated discrimination improvement (IDI) are increasingly important in the evaluation of the impact of the addition of new markers to multivariate algorithms and these are also discussed. en_US
dc.language.iso eng en_US
dc.publisher Springer-Verlag en_US
dc.relation.ispartofseries Calcified Tissue International;91(3), pp. 204-214
dc.relation.uri http://dx.doi.org/10.1007/s00223-012-9627-0
dc.rights The original publication is available at www.springerlink.com en_US
dc.subject fracture en_US
dc.subject DXA en_US
dc.subject prognostic en_US
dc.subject algorithms en_US
dc.subject FRAX en_US
dc.title Developing novel prognostic biomarkers for multivariate fracture risk prediction algorithms en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 1391653


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