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- Vandenput, Liesbeth, 1974, et al.
(författare)
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Update of the fracture risk prediction tool FRAX : a systematic review of potential cohorts and analysis plan
- 2022
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Ingår i: Osteoporosis International. - : Springer. - 0937-941X .- 1433-2965. ; 33:10, s. 2103-2136
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Forskningsöversikt (refereegranskat)abstract
- Summary: We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures.Introduction: The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors.Methods: A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible.Results: Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed.Conclusions: These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
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| 2. |
- Woods, P. J., et al.
(författare)
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A review of adaptation options in fisheries management to support resilience and transition under socio-ecological change
- 2022
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Ingår i: ICES Journal of Marine Science. - : Oxford University Press (OUP). - 1054-3139 .- 1095-9289. ; 79:2, s. 463-479
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Forskningsöversikt (refereegranskat)abstract
- Social-ecological systems dependent on fisheries must be resilient or adapt to remain viable in the face of change. Here, we identified possible interventions (termed “adaptation options”) from published literature, aimed at supporting social or ecological resilience and/or aiding adaptation to changes induced by environmental or social stressors. Our searches centered on nations/regions across North America, Europe, and the South Pacific, encompassing fisheries literature with and without a climate change focus, to compare how, when, and by whom interventions are currently or potentially implemented. We expected that adaptation options within a climate change context would have a greater focus on enhancing social resilience due to a connection with climate change adaptation assessment methodology. Instead, we found a greater focus on ecological resilience, likely indicating a focus on management adaptation. This pattern, along with the more extensive use of social adaptation options responsively and outside the context of climate change, along with an importance in bottom-up influences in implementing them, suggests a general lack of centralized planning and organization with regards to adaptation of stakeholders. Determining how adaptation options are created, chosen, and implemented is a crucial step within or external to ecosystem-based management, especially if planned stakeholder adaption is the goal.
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