The simple calculated ostoporosis risk estimation (SCORE) does not allow to identify Belgian women with a high risk of osteoporosis

in Osteoporosis International (2000), 11(S2), 3

Validation of the critera proposed by the Belgian social security institute for reimbursement of bone mineral density : a study in a sample of 4727 ambulatory subjects

in Arthritis and Rheumatism (2000), 43(S1), 453

The simple calculated osteoporosis risk estimation (SCORE) does not allow identification of Belgian women with a high risk of osteoporosis

in Annals of the Rheumatic Diseases (2000), 59(Suppl.1), 80

Limited clinical utility of a self-evaluating risk assessment scale for postmenopausal osteoporosis: lack of predictive value of lifestyle-related factors

in Calcified Tissue International (1999), 65(5), 354-358

The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 ... [more ▼]

The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 postmenopausal women completed the questionnaire based on 18 items. Bone mineral density at the lumbar spine (BMD-L), total hip (BMD-H), and femoral neck (BMD-N) was used as objective criterion for evaluation. The mean risk score was 8.2 +/- 3.21. BMD was correlated with total risk score: r = -0.32 for BMD-L, -0.36 for BMD-N, and -0.43 for BMD-H. Cutoff points for the risk score (equal likelihood points) according to a T-score threshold of -2.5 were 8.6 for BMD-L and BMD-N and 9.3 for BMD-H; specificity and sensitivity was 62% and 62%, respectively, for BMD-L, 65% and 62% for BMD-N, and 75% and 63% for BMD-H. Stepwise multiple regression analysis of the questionnaire items in relation to BMD showed higher correlation coefficients for models including individual items rather than the overall risk score. Items concerning low weight, older age, and wrist fracture after 50 years of age were always selected as significant determinants of BMD (R = 0.43-0.55). Hormonal replacement therapy was also an important determinant. Lifestyle-related items did not contribute significantly. In conclusion, the diagnostic performance of the 18-item self-administered questionnaire was poorer than a shortened questionnaire omitting lifestyle factors. The clinical utility of a questionnaire should ultimately be evaluated in the specific optic of a chosen global strategy for prevention of osteoporotic fractures. [less ▲]

Effects of an intensive communications strategies on postmenopausal osteoporosis awareness in women

in Arthritis and Rheumatism (1999), 42(S1), 356

Direct costs of hip fractures in patients over 60 years of age in Belgium.

in PharmacoEconomics (1999), 15(5), 507-514

OBJECTIVE: Osteoporosis-related costs are now considered a major burden for health authorities in most developed countries. An accurate and exhaustive evaluation of these costs would be a major ... [more ▼]

OBJECTIVE: Osteoporosis-related costs are now considered a major burden for health authorities in most developed countries. An accurate and exhaustive evaluation of these costs would be a major contribution to health economic studies evaluating the efficiency of screening and prevention strategies. Osteoporosis is the most frequent underlying cause of femoral neck fractures in the elderly; these fractures weigh heavily on healthcare budgets. However, in Belgium, very few data on the financial burden of hip fractures are available and no updated estimates have been made. The goal of this paper is to estimate the direct medical expenditures associated with hip fractures in Belgium in 1996. DESIGN AND SETTING: This 1-year population-based cross-sectional study is conducted from the social security perspective. The target population in this study are men and women aged 60 years and over. PATIENTS AND PARTICIPANTS: We selected patients who had been hospitalised for a hip fracture during the year 1996 who were also affiliated with a registered social security organisation (covering 25% of the Belgian population). The sample constituted 2374 patients. INTERVENTIONS: For each of these patients, we collected an exhaustive and detailed list of healthcare resource use as well as nursing home admissions following the hip fracture event. Cost items investigated in the analysis were inpatient hospital costs and outpatient costs. Mean annual costs per case recorded in the sample were then extrapolated to the whole country on the basis of an exhaustive list of diagnoses having lead to all countrywide hospitalisations (1,700,000 hospital stays/year). MAIN OUTCOME MEASURES AND RESULTS: The mean hospital inpatient costs for hip fracture were evaluated at 332,148 Belgian francs (BeF) [$US8977] per case and BeF4,367,746,200 ($US118,047,194) for the whole country (10 million inhabitants). Patients with a hip fracture experienced an annual BeF27,825 ($US752) extra outpatient cost during the year following this fracture event, after correcting for costs related to additional comorbidity already present before the hip fracture. Finally, after a proximal femoral neck fracture, the rate of nursing home admission was higher, both for men and women at any age compared with age- and gender-matched population. CONCLUSIONS: With a total cost (acute hospital and outpatient costs) of BeF4,667,894,950 ($US126,159,323) per year in Belgium, proximal femoral neck fracture should be considered a major health economic problem and appropriate measures to prevent this disease should be rapidly undertaken. [less ▲]

Les thérapeutiques à visée spécifiquement osseuse dans le traitement de l'ostéoporose postménopausique. Aspects pharmaco-économiques

in Revue Médicale de Liège (1998), 53(5), 290-293

Fairly new economic evaluations were, so far, properly conducted in the field of prevention and treatment of osteoporosis. This lack of studies is likely to be related to the pathophysiology and the ... [more ▼]

Fairly new economic evaluations were, so far, properly conducted in the field of prevention and treatment of osteoporosis. This lack of studies is likely to be related to the pathophysiology and the natural course of the disease, the small number of disease-specific instruments allowing the evaluation of quality of life changes following fractures and the frequent interaction of osteoporotic treatments with other body systems. Notwithstanding a lot of efforts have to be brought before economic evaluations in osteoporosis become a key determinant of Public Health strategies, it remains of prime interest to promote this type of research taking into account the importance of the social, human and economic burden of this disease. [less ▲]