Osteoporoza
Rokowania, prognozy i postęp choroby
Rokowanie w osteoporozie jest ściśle związane z wczesnym rozpoczęciem i konsekwentnym prowadzeniem terapii, która może spowolnić lub zatrzymać utratę masy kostnej. Osteoporoza sama w sobie nie skraca życia, jednak złamania osteoporotyczne, zwłaszcza biodra u osób powyżej 65 roku życia, wiążą się ze zwiększoną śmiertelnością i obniżoną mobilnością. Wczesne leczenie, szczególnie u mężczyzn przed 60. rokiem życia i kobiet przed 75. rokiem życia, pozwala na przeżycie co najmniej 15 lat po diagnozie. Kluczowe jest łączenie wartości BMD z czynnikami ryzyka klinicznego, co umożliwia dokładniejszą ocenę ryzyka złamań, np. za pomocą narzędzia FRAX, które szacuje 10-letnie ryzyko złamania biodra i innych złamań osteoporotycznych. Wartości progowe odpowiedzi na terapię to zmniejszenie BMD kręgosłupa lędźwiowego o mniej niż 3% lub całkowitego biodra/szyjki kości udowej o mniej niż 5%. Mimo dostępności licznych leków, około 25% pacjentów nie wykazuje poprawy BMD.
Rokowanie w osteoporozie
Rokowanie w osteoporozie (Osteoporoza) zależy przede wszystkim od tego, jak wcześnie pacjent rozpocznie leczenie i czy będzie je konsekwentnie kontynuował. Odpowiednio dobrana terapia może spowolnić lub nawet zatrzymać utratę masy kostnej, co pozwala zachować mocniejsze kości przez dłuższy czas.1 Chociaż osteoporoza nie jest chorobą śmiertelną, ma tendencję do postępowania z czasem, szczególnie przy braku leczenia. Stan ten nie wpływa bezpośrednio na długość życia, jednak osoby doświadczające złamań osteoporotycznych mogą mieć krótszą przewidywaną długość życia.12
Badania pokazują, że mężczyźni, którzy rozpoczynają leczenie przed 60 rokiem życia, oraz kobiety, które rozpoczynają terapię przed 75 rokiem życia, mogą oczekiwać, że będą żyć co najmniej 15 lat lub dłużej po diagnozie.3 Warto podkreślić, że sama osteoporoza nie jest śmiertelna, ale złamania (szczególnie złamania biodra) u osób powyżej 65 roku życia mogą prowadzić do zmniejszonej mobilności i przedwczesnego zgonu.4 Niekorzystne skutki osteoporozy, takie jak złamania biodra i kręgów, wiążą się ze znaczną chorobowością, śmiertelnością i kosztami ekonomicznymi.5
Czynniki wpływające na rokowanie
Najważniejszym czynnikiem wpływającym na rokowanie w osteoporozie jest to, czy pacjent podejmie leczenie i jak wcześnie w przebiegu choroby to zrobi.6 Wczesne rozpoznanie i leczenie może oznaczać, że pacjent traci mniej gęstości kości wraz z wiekiem, a w niektórych przypadkach może nawet odwrócić utratę masy kostnej.7 Jednak bez interwencji osteoporoza będzie się pogarszać.7
Właściwe leczenie w połączeniu ze zmianami stylu życia może poprawić rokowanie. Obecność klinicznych czynników ryzyka, szczególnie zaawansowany wiek, wcześniejsze złamania oraz ich częstość, liczba i ciężkość, może identyfikować pacjentów o wysokim ryzyku złamań, dostarczając informacji uzupełniających do wartości BMD (gęstości mineralnej kości).8
Oszacowanie ryzyka złamań
Połączenie wartości BMD i klinicznych czynników ryzyka lepiej przewiduje ryzyko złamań niż sama wartość BMD lub same czynniki ryzyka. Narzędzie do oceny ryzyka złamań (FRAX) łączy czynniki ryzyka klinicznego i BMD szyjki kości udowej w algorytmie komputerowym, który szacuje 10-letnie prawdopodobieństwo złamania biodra i dużego złamania osteoporotycznego.9 Stosowanie FRAX zapewnia ilościowe oszacowanie ryzyka złamania oparte na solidnych danych z dużych populacji mężczyzn i kobiet o różnorodności etnicznej i geograficznej.10
Opracowano również nowe algorytmy predykcji ryzyka (QFractureScores) do szacowania indywidualnego ryzyka złamania osteoporotycznego lub złamania biodra w okresie 10 lat. Czynniki takie jak stosowanie hormonalnej terapii zastępczej, wiek, BMI, palenie tytoniu, spożycie alkoholu, rodzinne występowanie osteoporozy, reumatoidalne zapalenie stawów, choroby układu sercowo-naczyniowego, cukrzyca typu 2, astma, stosowanie trójcyklicznych leków przeciwdepresyjnych, kortykosteroidów, upadki w wywiadzie, objawy menopauzy, przewlekłe choroby wątroby, zaburzenia wchłaniania w przewodzie pokarmowym i inne zaburzenia endokrynologiczne okazały się istotnie i niezależnie związane z ryzykiem złamania osteoporotycznego u kobiet.11
Nowe metody predykcji ryzyka osteoporozy
Wykorzystanie sztucznej inteligencji
W ostatnich latach rozwinięto nowe metody prognozowania ryzyka osteoporozy i odpowiedzi na leczenie z wykorzystaniem sztucznej inteligencji i uczenia maszynowego. W jednym z badań opracowano model obliczeniowy wykorzystujący 8981 zmiennych klinicznych (dane demograficzne, diagnozy, wyniki laboratoryjne, leki i początkowe wyniki BMD) z 10-letniego okresu elektronicznej dokumentacji medycznej do przewidywania odpowiedzi BMD po leczeniu.12 Wyniki wykazały, że średnia odpowiedź na leczenie zalecanych schematów była o 9,54% wyższa niż w przypadku rzeczywistych schematów.13
Proponowane systemy wspomagania decyzji klinicznych oparte na uczeniu maszynowym mogą identyfikować możliwe wzorce odpowiedzi BMD na różne schematy leczenia w oparciu o złożone osobiste dane kliniczne. Metoda ta stanowi zautomatyzowany proces przetwarzania danych, który może być potencjalnie zintegrowany z systemami EMR szpitala i może pomóc lekarzom w wyborze optymalnego schematu terapeutycznego w celu maksymalizacji wyników leczenia dostosowanego do indywidualnego pacjenta.14
Modele predykcyjne w osteoporozie
Opracowano również modele predykcyjne do oceny ryzyka osteoporozy. W jednym z badań porównano wydajność czterech modeli predykcyjnych, które uwzględniały historię chorób i nawyki życiowe w przewidywaniu ryzyka osteoporozy u dorosłych. Model jednoczynnikowy wykazał, że przyjmowanie tabletek wapnia (iloraz szans [OR]=0,431), SBP (OR=1,010), złamania (OR=1,796), choroba wieńcowa serca (OR=4,299), spożywanie alkoholu (OR=1,835), aktywność fizyczna (OR=0,747) i inne czynniki były związane z ryzykiem osteoporozy.15
W innym badaniu opracowano model uczenia maszynowego do przewidywania osteoporozy na podstawie danych z ogólnokrajowej opieki zdrowotnej. Osiągnięta wartość lift dla modelu stacker podkreśla jego zdolność do skutecznego identyfikowania przypadków osteoporozy w porównaniu z losowym wyborem, co potwierdza jego użyteczność kliniczną. Wartości SHAP, zaawansowane narzędzie do interpretacji modelu, były instrumentalne w określaniu znaczenia każdej cechy w naszych ramach predykcyjnych. Wiek i płeć okazały się najważniejszymi czynnikami, co jest zgodne z szerszą literaturą dotyczącą osteoporozy.16
Optymalny próg prawdopodobieństwa 0,52 uzyskany z indeksu Youdena podkreśla zrównoważone uwzględnienie zarówno czułości (prawdziwie dodatni wskaźnik), jak i swoistości (prawdziwie ujemny wskaźnik) w badaniu.17
Skuteczność modeli predykcyjnych
Model LightGBM przewyższył inne modele predykcyjne z wynikiem F1 0,914, MCC 0,831 i AUC 0,970 na zestawie treningowym. Na zestawie testowym osiągnął wynik F1 0,912, MCC 0,826 i AUC 0,972. Model predykcji osteoporozy zbudowany przy użyciu LightGBM wykazał lepszą generalizowalność i odporność.1819
W innym badaniu skuteczność predykcyjna osteoporozy kości udowej przy użyciu analizy uczenia maszynowego z cechami radiomicznymi i tomografią komputerową jamy brzusznej i miednicy (APCT) wykazała wysoką trafność z dokładnością, swoistością i negatywną wartością predykcyjną przekraczającą 93%. Dokładność predykcji osteoporozy wyniosła 95,9% i 96,0% odpowiednio w kohortach treningowych i walidacyjnych.20
Odpowiedź na leczenie osteoporozy
Ocena skuteczności terapii
Cele leczenia osteoporozy obejmują zmniejszenie ryzyka złamań osteoporotycznych i poprawę gęstości mineralnej kości (BMD), która jest złotym standardem w diagnostyce osteoporozy i ocenie odpowiedzi na terapię.21 Zmniejszenie mniej niż 3% BMD kręgosłupa lędźwiowego lub mniej niż 5% całkowitego biodra lub szyjki kości udowej jest uważane za odpowiedź na terapię, podczas gdy osoby, które mają nowe złamania lub zmniejszenie BMD przekraczające wyżej wymienione kryteria, są uważane za nieadekwatną odpowiedź.22
Mimo że dostępny jest coraz szerszy zakres zatwierdzonych opcji terapeutycznych, takich jak słabe antyresorpcyjne, silne antyresorpcyjne lub anaboliczne środki, które skutecznie poprawiają BMD i zapobiegają złamaniom, jedna czwarta pacjentów z osteoporozą otrzymujących leczenie nie odpowiada poprawą BMD. Wskaźnik niepowodzeń jest wysoki, ponieważ wynik leczenia nie zależy tylko od schematów leczenia i dawkowania.23
Długoterminowa opieka
Pacjenci z osteoporozą powinni oczekiwać, że będą zarządzać swoją chorobą przez długi czas, zwykle przez resztę życia. Konieczne są regularne wizyty u lekarza i badania gęstości kości. Lekarz będzie monitorował wszelkie zmiany w gęstości kości i w razie potrzeby dostosowywał leczenie.24
Najlepszym sposobem zapobiegania złamaniom kości jest wykrycie osteoporozy, zanim może ona wyrządzić szkodę. Zaleca się regularne wizyty u lekarza, który poinformuje, kiedy należy wykonać badania gęstości kości i jak często należy wykonywać badania kontrolne w celu monitorowania zdrowia kości.25
Znaczenie wczesnej diagnostyki
Wczesne przewidywanie i identyfikacja osteoporozy może utorować drogę do terminowych interwencji, potencjalnie spowalniając lub nawet odwracając utratę masy kostnej.26 Niestety, osteoporoza często pozostaje niezdiagnozowana i nieleczona aż do wystąpienia osłabiającego złamania, dlatego proaktywna identyfikacja osób o wysokim ryzyku jest krytycznym krokiem w łagodzeniu obciążenia chorobą.27
Indeks OSTA (Osteoporosis Self-Assessment Tool for Asians) okazał się prostym i skutecznym narzędziem do rozpoznawania ryzyka osteoporozy. Oprócz oznaczania kohorty z ryzykiem osteoporozy, indeks OSTA może przewidywać rokowanie neurologiczne u pacjentów z izolowanym umiarkowanym urazem mózgu.28
Technologiczne wsparcie prognozowania
Wykorzystanie uczenia maszynowego w opiece zdrowotnej staje się coraz bardziej powszechne. W przypadku osteoporozy, zidentyfikowanie wzrostu, wieku i płci jako najważniejszych predyktorów daje kluczowy wgląd w czynniki demograficzne i fizjologiczne, które klinicyści powinni brać pod uwagę podczas oceny profili ryzyka pacjentów.29
Systemy wspomagania decyzji oparte na uczeniu maszynowym mogą być potencjalnie wykorzystywane wraz z odpowiednimi informacjami o pacjencie do informowania o nowym sposobie poprawy skuteczności terapeutycznej w leczeniu osteoporozy.30 Ta alternatywna metoda może pomóc lekarzom w wyborze optymalnego schematu terapeutycznego w celu maksymalizacji indywidualnego wyniku leczenia.31
Badania przesiewowe z wykorzystaniem tych metod mogą przyczynić się do zmniejszenia lub zapobiegania niepotrzebnym podwójnym kontrolom i kosztom badania DXA. Ogólnie rzecz biorąc, oportunistyczne badania przesiewowe w kierunku osteoporozy kości udowej z analizą uczenia maszynowego i APCT wykazały wysoką potencjalną wykonalność.32
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Materiały źródłowe
- #1 Osteoporosis prognosis, life expectancy, and morehttps://www.medicalnewstoday.com/articles/osteoporosis-prognosis
The outlook for osteoporosis mainly depends on how early someone seeks treatment and whether they continue with it. Treatment can slow or stop bone loss, keeping bones stronger for longer. […] Osteoporosis is not a terminal illness, but it does tend to worsen with time, especially without treatment. The condition does not directly influence life expectancy, though people who experience fractures from osteoporosis may have a shorter life span. Osteoporosis may also worsen the outlook of other diagnoses. […] With treatment, the outlook for osteoporosis is generally good. Treatment can slow or even reverse bone loss. […] All people steadily lose bone mineral density with age. Therefore, without treatment, osteoporosis tends to steadily worsen. […] The most important factor affecting someone’s outlook for osteoporosis is whether they seek treatment and how early in the disease they do so.
- #2 Osteoporosis: Prognosis, Complications, and Treatmenthttps://www.verywellhealth.com/osteoporosis-prognosis-6979280
People living with osteoporosis experience a reduced quality of life and lower life expectancy rates. The length of time a person can live with osteoporosis depends on their treatment and the age when they were diagnosed. […] When looking at the average, research has shown that males who begin treatment before 60 and women who begin treatment before 75 can expect to live 15 years or more following their diagnosis. […] Osteoporosis is a progressive condition. While it is not considered fatal in and of itself, it does shorten a person’s life expectancy. That is especially true if someone does not receive adequate treatment. However, people with osteoporosis can expect to live 15 years or more after their diagnosis if they take the proper medications and make the necessary lifestyle changes.
- #3 Osteoporosis: Prognosis, Complications, and Treatmenthttps://www.verywellhealth.com/osteoporosis-prognosis-6979280
People living with osteoporosis experience a reduced quality of life and lower life expectancy rates. The length of time a person can live with osteoporosis depends on their treatment and the age when they were diagnosed. […] When looking at the average, research has shown that males who begin treatment before 60 and women who begin treatment before 75 can expect to live 15 years or more following their diagnosis. […] Osteoporosis is a progressive condition. While it is not considered fatal in and of itself, it does shorten a person’s life expectancy. That is especially true if someone does not receive adequate treatment. However, people with osteoporosis can expect to live 15 years or more after their diagnosis if they take the proper medications and make the necessary lifestyle changes.
- #4 Osteoporosis: Symptoms, Causes and Treatmenthttps://my.clevelandclinic.org/health/diseases/4443-osteoporosis
You should expect to manage osteoporosis for a long time, usually the rest of your life. You’ll need regular appointments with a healthcare provider and bone density tests. Your provider will monitor any changes in your bone density and will adjust your treatments as needed. […] Osteoporosis itself isn’t fatal and won’t change your life expectancy (how long you’ll live). But it can make you more likely to experience a bone fracture (and can increase your risk of more severe breaks or complications from a fracture). Some studies have found that hip fractures in adults older than 65 lead to reduced mobility and an earlier death. […] The best way to prevent bone fractures is catching osteoporosis before it can hurt you. Visit a healthcare provider for regular checkups. Ask them when you’ll need bone density tests and how often you should have follow-up tests to monitor your bone health.
- #5 Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data | Scientific Reportshttps://www.nature.com/articles/s41598-024-56114-1
Osteoporosis is a major public health concern that significantly increases the risk of fractures. […] The aim of this study was to develop a Machine Learning based predictive model to screen individuals at high risk of osteoporosis based on chronic disease data, thus facilitating early detection and personalized management. […] In this study, a predictive model for osteoporosis based on chronic disease data was developed using machine learning. The model shows great potential in early detection and risk stratification of osteoporosis, ultimately facilitating personalized prevention and management strategies. […] The adverse outcomes of osteoporosis such as hip and vertebral fractures are associated with substantial morbidity, mortality, and economic costs. […] Unfortunately, osteoporosis often remains undiagnosed and untreated until the occurrence of a debilitating fracture, hence proactive identification of high-risk individuals is a critical step in mitigating the disease burden.
- #6 Osteoporosis prognosis, life expectancy, and morehttps://www.medicalnewstoday.com/articles/osteoporosis-prognosis
The outlook for osteoporosis mainly depends on how early someone seeks treatment and whether they continue with it. Treatment can slow or stop bone loss, keeping bones stronger for longer. […] Osteoporosis is not a terminal illness, but it does tend to worsen with time, especially without treatment. The condition does not directly influence life expectancy, though people who experience fractures from osteoporosis may have a shorter life span. Osteoporosis may also worsen the outlook of other diagnoses. […] With treatment, the outlook for osteoporosis is generally good. Treatment can slow or even reverse bone loss. […] All people steadily lose bone mineral density with age. Therefore, without treatment, osteoporosis tends to steadily worsen. […] The most important factor affecting someone’s outlook for osteoporosis is whether they seek treatment and how early in the disease they do so.
- #7 Osteoporosis prognosis, life expectancy, and morehttps://www.medicalnewstoday.com/articles/osteoporosis-prognosis
Most people with the condition have a close-to-typical life expectancy. […] Osteoporosis can also influence life expectancy indirectly. […] Osteoporosis is not directly fatal, and it is not a terminal illness. However, it may lead to significant pain, weakness, and disability if a person experiences fractures. […] With treatment, the outlook for osteoporosis can be favorable. Early diagnosis and treatment can mean a person stops losing as much bone density as they age, and in some cases, may even reverse bone loss to an extent. […] However, without intervention, osteoporosis will worsen. The right treatment, coupled with lifestyle changes, can improve outcomes.
- #8 Osteoporosis: Clinical Evaluation – Endotext – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK279049/
Osteoporosis is a common systemic skeletal disease characterized by low bone strength that results in an increased risk of fracture. Fractures are associated with serious clinical consequences, including pain, disability, loss of independence, and death, as well as high healthcare costs. Early identification and intervention with patients at high risk for fracture is needed to reduce the burden of osteoporotic fractures. […] The presence of clinical risk factors (CRFs) that are independent of BMD, particularly advancing age, prior fracture, and recency/number/severity of fracture(s), can identify patients at high-risk for fracture by providing information on fracture risk that is complementary to BMD. […] The combination of BMD and clinical risk factors (CRFs) predicts fracture risk better than BMD or CRFs alone. A fracture risk assessment tool (FRAX) combines CRFs and femoral neck BMD in a computer-based algorithm that estimates the 10-year probability of hip fracture and major osteoporotic fracture.
- #9 Osteoporosis: Clinical Evaluation – Endotext – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK279049/
Osteoporosis is a common systemic skeletal disease characterized by low bone strength that results in an increased risk of fracture. Fractures are associated with serious clinical consequences, including pain, disability, loss of independence, and death, as well as high healthcare costs. Early identification and intervention with patients at high risk for fracture is needed to reduce the burden of osteoporotic fractures. […] The presence of clinical risk factors (CRFs) that are independent of BMD, particularly advancing age, prior fracture, and recency/number/severity of fracture(s), can identify patients at high-risk for fracture by providing information on fracture risk that is complementary to BMD. […] The combination of BMD and clinical risk factors (CRFs) predicts fracture risk better than BMD or CRFs alone. A fracture risk assessment tool (FRAX) combines CRFs and femoral neck BMD in a computer-based algorithm that estimates the 10-year probability of hip fracture and major osteoporotic fracture.
- #10 Osteoporosis: Clinical Evaluation – Endotext – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK279049/
The use of FRAX provides a quantitative estimation of fracture risk that is based on robust data in large populations of men and women with ethnic and geographic diversity. […] To generate a valid FRAX output, the responses to CRF questions must be correct; for example, an incorrect entry of self-reported rheumatoid arthritis or use of glucocorticoids could skew the results toward overestimation of fracture risk. […] The reported prevalence of secondary osteoporosis varies depending on the study population, the extent of the medical evaluation, and definitions for laboratory abnormalities. It is likely that many or most patients with osteoporosis have clinically significant contributing factors that may influence patient management.
- #11 Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores | The BMJhttps://www.bmj.com/content/339/bmj.b4229
Objective To develop and validate two new fracture risk algorithms (QFractureScores) for estimating the individual risk of osteoporotic fracture or hip fracture over 10 years. […] Use of hormone replacement therapy (HRT), age, body mass index (BMI), smoking status, recorded alcohol use, parental history of osteoporosis, rheumatoid arthritis, cardiovascular disease, type 2 diabetes, asthma, tricyclic antidepressants, corticosteroids, history of falls, menopausal symptoms, chronic liver disease, gastrointestinal malabsorption, and other endocrine disorders were significantly and independently associated with risk of osteoporotic fracture in women. […] The hip fracture algorithm had the best performance among men and women. It explained 63.94% of the variation in women and 63.19% of the variation in men.
- #12 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
Osteoporosis is a global health problem for ageing populations. The goals of osteoporosis treatment are to improve bone mineral density (BMD) and prevent fractures. […] We developed a computational model from 8981 clinical variables, including demographic data, diagnoses, laboratory results, medications, and initial BMD results, taken from 10-year period of electronic medical records to predict BMD response after treatment. […] The results showed that the average treatment response of the recommended regimens was 9.54% higher than the actual regimens. In summary, our novel approach using a machine learning-based decision support system is capable of predicting BMD response after osteoporosis treatment and personalising the most appropriate treatment regimen for an individual patient. […] The goals of osteoporosis treatment are to reduce risk of osteoporotic fractures and improve bone mineral density (BMD), a gold standard tool for diagnosing osteoporosis and assessing response to therapy.
- #13 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
We believe that machine learning-based decision support systems could be potentially leveraged with relevant patient information to inform a new way of improving therapeutic effectiveness in osteoporosis treatment. […] We proposed a personalized osteoporosis treatment approach guided by a machine learning model prediction. […] The dataset of 13,562 osteoporosis treatment profiles taken from January 2011 to December 2019 were used for this study. […] The Random Forests model achieved the highest overall performance in the testing dataset with Accuracy = 0.69, Precision = 0.70, Recall = 0.89, F1-score = 0.78, ROC = 0.70. […] The proposed machine-learning model identifies possible BMD response patterns of different treatments based on complex personal clinical data. […] The difference of average probability between actual and recommended regimens were 8.36% in the response group, 11.47% in the inadequate response group, and 9.54% in the whole testing dataset.
- #14 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
This study demonstrated the development of a machine learning-based clinical decision support system. […] This method is an automated data pipeline process which can be potentially integrated into hospital EMR systems. […] This alternative approach can aid physicians to select an optimal therapeutic regimen in order to maximize a patient-specific treatment outcome.
- #15 Prediction model for the risk of osteoporosis incorporating factors of disease history and living habits in physical examination of population in Chongqing, Southwest China: based on artificial neural network | BMC Public Health | Full Texthttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11002-5
Osteoporosis is a gradually recognized health problem with risks related to disease history and living habits. This study aims to establish the optimal prediction model by comparing the performance of four prediction models that incorporated disease history and living habits in predicting the risk of Osteoporosis in Chongqing adults. […] The univariate logistic model found that taking calcium tablet (odds ratio [OR]=0.431), SBP (OR=1.010), fracture (OR=1.796), coronary heart disease (OR=4.299), drinking alcohol (OR=1.835), physical exercise (OR=0.747) and other factors were related to the risk of osteoporosis. […] Compared with DBN, SVM and GA-DT, the established ANN model had the best prediction ability and can be used to predict the risk of osteoporosis in physical examination of the Chongqing population. The model needs to be further improved through large sample research. […] The ANN model results showed that if the probability was more significant than 0.330, osteoporosis would occur. Further researches are needed to validate our model to predict the risk of osteoporosis in adults.
- #16 Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data | Scientific Reportshttps://www.nature.com/articles/s41598-024-56114-1
Early prediction and identification of osteoporosis can pave the way for timely interventions, potentially decelerating or even reversing bone loss. […] This study, by capitalizing on nationwide primary healthcare data from Germany, offers a non-invasive and efficient means to predict osteoporosis risk based on health indicators and chronic conditions. […] The achieved lift value of 1.9 for the stacker model accentuates its ability to effectively identify osteoporosis cases compared to random selection, validating its clinical utility. […] The significance of lipid metabolism disorders in predicting osteoporosis in our model presented intriguing insights. […] The SHAP values, an advanced tool for model interpretability, were instrumental in determining the salience of each feature within our predictive framework. Age and gender emerged as the most paramount factors, a finding that resonates with the broader osteoporosis literature.
- #17 Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data | Scientific Reportshttps://www.nature.com/articles/s41598-024-56114-1
The imperative of early osteoporosis prediction has never been clearer. […] The choice of algorithms in the present study was pivotal in ensuring robust prediction performance. […] The optimal threshold probability of 0.52 derived from the Youden index underscores the balanced consideration of both sensitivity (true positive rate) and specificity (true negative rate) in the study. […] The current research serves as a testament to the potential of machine learning in advancing osteoporosis prediction, highlighting a novel approach that melds the power of various predictive algorithms.
- #18 PrOsteoporosis: predicting osteoporosis risk using NHANES data and machine learning approach | BMC Research Notes | Full Texthttps://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-025-07089-3
Osteoporosis, prevalent among the elderly population, is primarily diagnosed through bone mineral density (BMD) testing, which has limitations in early detection. […] This study demonstrates the potential of machine learning models in assessing an individuals risk of developing osteoporosis, a condition that significantly impacts quality of life and imposes substantial healthcare costs. […] Importantly, identifying height, age, and sex as top predictors offers critical insights into the demographic and physiological factors that clinicians should consider when evaluating patients risk profiles. […] The LightGBM model outperformed others with an F1 score of 0.914, an MCC of 0.831, and an AUC of 0.970 on the training set. […] On the test set, it achieved an F1 score of 0.912, an MCC of 0.826, and an AUC of 0.972.
- #19 PrOsteoporosis: predicting osteoporosis risk using NHANES data and machine learning approach | BMC Research Notes | Full Texthttps://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-025-07089-3
Therefore, the osteoporosis prediction model constructed using the LightGBM demonstrated better generalizability and robustness. […] Our study has several limitations that should be acknowledged and considered in future research. […] These findings suggest that machine learning can be comprehensively applied to healthcare big data for risk analysis of certain diseases.
- #20 Prediction of femoral osteoporosis using machine-learning analysis with radiomics features and abdomen-pelvic CT: A retrospective single center preliminary study | PLOS Onehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247330
Osteoporosis has increased and developed into a serious public health concern worldwide. […] The prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT showed high validity with more than 93% accuracy, specificity, and negative predictive value. […] The prediction accuracy of osteoporosis was 95.9% and 96.0% in the training and validation cohorts, respectively. […] Therefore, screening using this method may contribute to reduce or prevent the unnecessary duplication check and cost of DXA. […] Overall, opportunistic screening of femoral osteoporosis with machine-learning analysis and APCT has shown high potential feasibility.
- #21 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
Osteoporosis is a global health problem for ageing populations. The goals of osteoporosis treatment are to improve bone mineral density (BMD) and prevent fractures. […] We developed a computational model from 8981 clinical variables, including demographic data, diagnoses, laboratory results, medications, and initial BMD results, taken from 10-year period of electronic medical records to predict BMD response after treatment. […] The results showed that the average treatment response of the recommended regimens was 9.54% higher than the actual regimens. In summary, our novel approach using a machine learning-based decision support system is capable of predicting BMD response after osteoporosis treatment and personalising the most appropriate treatment regimen for an individual patient. […] The goals of osteoporosis treatment are to reduce risk of osteoporotic fractures and improve bone mineral density (BMD), a gold standard tool for diagnosing osteoporosis and assessing response to therapy.
- #22 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
A decrease of less than 3% of lumbar BMD or less than 5% total hip or femoral neck BMD are considered response to therapy, while those who have new fractures or a BMD decrease exceeding the aforementioned criteria are considered inadequate response. […] Although there is an increasing range of approved therapeutic options; for instance, weak antiresorptive, potent antiresorptive, or anabolic agents that efficiently improve BMD and prevent fractures, one fourth of osteoporosis patients receiving treatment fail to respond with BMD improvement. […] The failure rate is high because the treatment outcome does not only depend on treatment regimens and dosage. […] These strategies seem to help to increase the successful rate of treatment outcomes and are reasonable to apply in clinical practice, but it is hard to find a clear and discrete protocol to make universal decisions because of the uncertainty of clinical adjustment and complex information regarding individual clinical factors and personal history.
- #23 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
A decrease of less than 3% of lumbar BMD or less than 5% total hip or femoral neck BMD are considered response to therapy, while those who have new fractures or a BMD decrease exceeding the aforementioned criteria are considered inadequate response. […] Although there is an increasing range of approved therapeutic options; for instance, weak antiresorptive, potent antiresorptive, or anabolic agents that efficiently improve BMD and prevent fractures, one fourth of osteoporosis patients receiving treatment fail to respond with BMD improvement. […] The failure rate is high because the treatment outcome does not only depend on treatment regimens and dosage. […] These strategies seem to help to increase the successful rate of treatment outcomes and are reasonable to apply in clinical practice, but it is hard to find a clear and discrete protocol to make universal decisions because of the uncertainty of clinical adjustment and complex information regarding individual clinical factors and personal history.
- #24 Osteoporosis: Symptoms, Causes and Treatmenthttps://my.clevelandclinic.org/health/diseases/4443-osteoporosis
You should expect to manage osteoporosis for a long time, usually the rest of your life. You’ll need regular appointments with a healthcare provider and bone density tests. Your provider will monitor any changes in your bone density and will adjust your treatments as needed. […] Osteoporosis itself isn’t fatal and won’t change your life expectancy (how long you’ll live). But it can make you more likely to experience a bone fracture (and can increase your risk of more severe breaks or complications from a fracture). Some studies have found that hip fractures in adults older than 65 lead to reduced mobility and an earlier death. […] The best way to prevent bone fractures is catching osteoporosis before it can hurt you. Visit a healthcare provider for regular checkups. Ask them when you’ll need bone density tests and how often you should have follow-up tests to monitor your bone health.
- #25 Osteoporosis: Symptoms, Causes and Treatmenthttps://my.clevelandclinic.org/health/diseases/4443-osteoporosis
You should expect to manage osteoporosis for a long time, usually the rest of your life. You’ll need regular appointments with a healthcare provider and bone density tests. Your provider will monitor any changes in your bone density and will adjust your treatments as needed. […] Osteoporosis itself isn’t fatal and won’t change your life expectancy (how long you’ll live). But it can make you more likely to experience a bone fracture (and can increase your risk of more severe breaks or complications from a fracture). Some studies have found that hip fractures in adults older than 65 lead to reduced mobility and an earlier death. […] The best way to prevent bone fractures is catching osteoporosis before it can hurt you. Visit a healthcare provider for regular checkups. Ask them when you’ll need bone density tests and how often you should have follow-up tests to monitor your bone health.
- #26 Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data | Scientific Reportshttps://www.nature.com/articles/s41598-024-56114-1
Early prediction and identification of osteoporosis can pave the way for timely interventions, potentially decelerating or even reversing bone loss. […] This study, by capitalizing on nationwide primary healthcare data from Germany, offers a non-invasive and efficient means to predict osteoporosis risk based on health indicators and chronic conditions. […] The achieved lift value of 1.9 for the stacker model accentuates its ability to effectively identify osteoporosis cases compared to random selection, validating its clinical utility. […] The significance of lipid metabolism disorders in predicting osteoporosis in our model presented intriguing insights. […] The SHAP values, an advanced tool for model interpretability, were instrumental in determining the salience of each feature within our predictive framework. Age and gender emerged as the most paramount factors, a finding that resonates with the broader osteoporosis literature.
- #27 Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data | Scientific Reportshttps://www.nature.com/articles/s41598-024-56114-1
Osteoporosis is a major public health concern that significantly increases the risk of fractures. […] The aim of this study was to develop a Machine Learning based predictive model to screen individuals at high risk of osteoporosis based on chronic disease data, thus facilitating early detection and personalized management. […] In this study, a predictive model for osteoporosis based on chronic disease data was developed using machine learning. The model shows great potential in early detection and risk stratification of osteoporosis, ultimately facilitating personalized prevention and management strategies. […] The adverse outcomes of osteoporosis such as hip and vertebral fractures are associated with substantial morbidity, mortality, and economic costs. […] Unfortunately, osteoporosis often remains undiagnosed and untreated until the occurrence of a debilitating fracture, hence proactive identification of high-risk individuals is a critical step in mitigating the disease burden.
- #28 Osteoporosis Self-Assessment Tool for Asians Can Predict Neurologic Prognosis in Patients with Isolated Moderate Traumatic Brain Injury | PLOS Onehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132685
Osteoporosis Self-Assessment Tool for Asians (OSTA) has been proved to be a simple and effective tool for recognizing osteoporosis risk. […] In addition to labeling the cohort harboring osteoporotic risk, OSTA index could predict neurologic prognosis in patients with isolated moderate traumatic brain injury. […] Higher ISS, lower OSTA index and exposure to neurosurgery are the independent risk factors for poorer recovery from isolated moderate traumatic brain injury. The OSTA index could provide additional merit in traumatic prognostication in addition to labelling the cohort harboring osteoporotic risk.
- #29 PrOsteoporosis: predicting osteoporosis risk using NHANES data and machine learning approach | BMC Research Notes | Full Texthttps://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-025-07089-3
Osteoporosis, prevalent among the elderly population, is primarily diagnosed through bone mineral density (BMD) testing, which has limitations in early detection. […] This study demonstrates the potential of machine learning models in assessing an individuals risk of developing osteoporosis, a condition that significantly impacts quality of life and imposes substantial healthcare costs. […] Importantly, identifying height, age, and sex as top predictors offers critical insights into the demographic and physiological factors that clinicians should consider when evaluating patients risk profiles. […] The LightGBM model outperformed others with an F1 score of 0.914, an MCC of 0.831, and an AUC of 0.970 on the training set. […] On the test set, it achieved an F1 score of 0.912, an MCC of 0.826, and an AUC of 0.972.
- #30 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
We believe that machine learning-based decision support systems could be potentially leveraged with relevant patient information to inform a new way of improving therapeutic effectiveness in osteoporosis treatment. […] We proposed a personalized osteoporosis treatment approach guided by a machine learning model prediction. […] The dataset of 13,562 osteoporosis treatment profiles taken from January 2011 to December 2019 were used for this study. […] The Random Forests model achieved the highest overall performance in the testing dataset with Accuracy = 0.69, Precision = 0.70, Recall = 0.89, F1-score = 0.78, ROC = 0.70. […] The proposed machine-learning model identifies possible BMD response patterns of different treatments based on complex personal clinical data. […] The difference of average probability between actual and recommended regimens were 8.36% in the response group, 11.47% in the inadequate response group, and 9.54% in the whole testing dataset.
- #31 Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy | Scientific Reportshttps://www.nature.com/articles/s41598-021-93152-5
This study demonstrated the development of a machine learning-based clinical decision support system. […] This method is an automated data pipeline process which can be potentially integrated into hospital EMR systems. […] This alternative approach can aid physicians to select an optimal therapeutic regimen in order to maximize a patient-specific treatment outcome.
- #32 Prediction of femoral osteoporosis using machine-learning analysis with radiomics features and abdomen-pelvic CT: A retrospective single center preliminary study | PLOS Onehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247330
Osteoporosis has increased and developed into a serious public health concern worldwide. […] The prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT showed high validity with more than 93% accuracy, specificity, and negative predictive value. […] The prediction accuracy of osteoporosis was 95.9% and 96.0% in the training and validation cohorts, respectively. […] Therefore, screening using this method may contribute to reduce or prevent the unnecessary duplication check and cost of DXA. […] Overall, opportunistic screening of femoral osteoporosis with machine-learning analysis and APCT has shown high potential feasibility.