References of "Ethgen, Olivier"
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See detailEfficiency and recommendations for osteoporosis screening strategy
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in Osteoporosis International (2008, April), 19(S1), 116

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See detailLifetime absolute risk of hip and other osteoporotic fracture in Belgian women.
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in BONE (2008), 43(6), 991-4

OBJECTIVES: To estimate the lifetime absolute risks of hip and other osteoporotic fracture in Belgian women aged 60 years and to examine the effect of changes in baseline population fracture risk and ... [more ▼]

OBJECTIVES: To estimate the lifetime absolute risks of hip and other osteoporotic fracture in Belgian women aged 60 years and to examine the effect of changes in baseline population fracture risk and changes in life expectancy. MATERIALS AND METHODS: Estimates were performed using a Markov microsimulation model and were based on the incidence of first fracture as well as life expectancy. Baseline scenario included projected mortality rates and increasing fracture incidence by 1% per year. Alternative scenarios were performed on age, life expectancy and trends in fracture incidence. Lifetime fracture risk for osteoporotic population (T-score <or= -2.5) was also estimated. RESULTS: In the baseline scenario, lifetime absolute risks of hip fracture and of any major osteoporotic fracture (hip, clinical vertebral or wrist) were respectively 24.8% and 44.3%. Alternative scenarios showed that when assuming no change of age-specific fracture rates over time, these lifetime risks were 18.3% and 35.2%, while these values were 20.0% and 38.3% assuming no future mortality reductions. For osteoporotic women, these values were respectively 34.5% and 51.5%. CONCLUSION: We conclude that absolute lifetime fracture risks are substantial and that trends in fracture incidence and changes in life expectancy have a marked impact on absolute lifetime fracture risks. [less ▲]

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See detailUtility values associated with osteoporotic fracture: a systematic review of the literature.
Hiligsmann, Mickaël ULg; Ethgen, Olivier ULg; Richy, Florent et al

in Calcified Tissue International (2008), 82(4), 288-92

We reviewed studies that have estimated the impact of osteoporotic fracture on quality-adjusted life years (QALY) and to determine reference values for countries that would like to carry out cost-utility ... [more ▼]

We reviewed studies that have estimated the impact of osteoporotic fracture on quality-adjusted life years (QALY) and to determine reference values for countries that would like to carry out cost-utility analyses but that do not have their own values. The computerized medical literature databases Medline and EMBASE were searched from January 1990 to December 2006. The search was carried out in two steps. The first step was to identify studies that related to quality of life in osteoporosis. As part of the second step, only the studies that translated quality of life into a utility value (one single value for health status ranging 0-1) and calculated a utility loss over a period of at least 1 year were selected. From the 152 studies identified in the first analysis, only 16 were retained after the second step. Ten studies investigated utility values for hip fractures, 11 for vertebral fractures, five for distal forearm fractures, and four for other osteoporotic fractures and fracture interactions. Utility values differed substantially between studies, partly due to the valuation technique used, the severity of fractures, and the sample size. This review suggests that there is no meaningful average value across different studies, different samples, different countries, or different instruments. Although we tried to determine the best available values, these values do not preclude the need for country-specific studies. Finally, we also make recommendations regarding the design and methodology for such studies. [less ▲]

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See detailAn Economic Evaluation of Quantitative Ultrasonometry as Pre-Screening Test for the Identification of Patients with Osteoporosis
Hiligsmann, Mickaël ULg; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Disease Management & Health Outcomes (2008), 16(6), 429-438

Background: Screening for osteoporosis has been recommended to identify patients at high risk of fracture in order to provide preventative treatment. Given the limited availability of dual-energy x-ray ... [more ▼]

Background: Screening for osteoporosis has been recommended to identify patients at high risk of fracture in order to provide preventative treatment. Given the limited availability of dual-energy x-ray absorptiometry (DXA) and health resources, quantitative ultrasonometry (QUS) has emerged as an attractive tool for the mass screening scenario. The objective of this study was to evaluate whether a screening strategy using QUS as a pre-screening tool for bone densitometry would be cost effective and, if so, at what cut-off thresholds. Methods: Decision analytic models were used to compare the cost effectiveness and cost utility of several screening strategies: DXA measurement alone and pre-screening strategies that use different QUS index cut-off thresholds. For each strategy, and for hypothetical cohorts of women, we estimated the number of DXA scans required, the number of osteoporotic patients detected and missed, the total screening cost, and the incremental cost per patient detected. A validated Markov microsimulation model with a lifetime horizon and from a healthcare perspective was also computed in order to estimate the cost per quality-adjusted life-year (QALY) gained of the alternative screening strategies combined with 5 years of alendronate therapy for women who have osteoporosis (T-score -2.5 or less). Results: The DXA strategy had the highest cost and the highest number of patients with osteoporosis detected. Pre-screening strategies using QUS reduced the number of DXA scans per patient with osteoporosis detected and the total screening cost but they also missed patients with osteoporosis as the QUS index decreased. Pre-screening strategies using QUS T-scores of 0.0, -0.5, -2.0, and -2.5 were dominated by extended dominance, as their incremental cost-effectiveness ratios (ICERs) and incremental cost-utility ratios (ICURs) were higher than that of the next more effective alternative. The cost-effectiveness and cost-utility frontiers included no screening, pre-screening using QUS T-scores of -1.0 and -1.5, and DXA measurement alone. Conclusion: These results suggest that QUS may be useful as a pre-screening tool for bone densitometry given the limited availability of DXA and health resources, and that the QUS index T-scores of -1.0 and -1.5 are the most appropriate index. [less ▲]

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See detailCost-effectiveness of osteoporosis screening campaign for Belgian women
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in Value in Health (2007, October), 10(6), 395

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See detailRationale and development of an individual patient-based model to accurately assess the efficacy of osteoporosis management
Hiligsmann, Mickaël ULg; Richy, Florent; Ethgen, Olivier ULg et al

in Osteoporosis International (2007, March), 18(S1), 169

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See detailPrevention of hip fractures in osteoporosis
Neuprez, Audrey ULg; Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg et al

in Minerva Ortopedica e Traumatologica (2007), 58(5), 423-437

Hip fracture is the major clinical consequence of osteoporosis. It is linked with decreased life expectancy and quality of life, placing an ever increasing burden on health services. Few medications have ... [more ▼]

Hip fracture is the major clinical consequence of osteoporosis. It is linked with decreased life expectancy and quality of life, placing an ever increasing burden on health services. Few medications have unequivocally demonstrated their ability to reduce hip fracture risk in osteoporotic subjects. Daily alendronate and risedronate reduce hip fracture in patients with low bone mineral density and prevalent vertebral fractures. Intravenous bisphosphonates have been developed, in response to long-term poor adherence to oral anti-osteoporotic treatments. Once-yearly zoledronic acid reduces fracture rates at the spine, non-spine and hip locations. Strontium ranelate, the first drug to uncouple bone formation from bone resorption has also demonstrated its ability to reduce hip fractures in patients above 74 years old, with prevalent low bone mineral density. Calcium and vitamin D supplementation are prerequisite for the management of elderly subjects and should always been associated to anti-resorptive or bone forming agents. Non-pharmacological management of osteoporosis is recommended cannot be considered a substitute for pharmacological treatment of osteoporosis, not even in old age. [less ▲]

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See detailA naturalistic study of the determinants of health related quality of life improvement in osteoarthritic patients treated with non-specific non-steroidal antiinflammatory drugs
Rabenda, Véronique ULg; Burlet, N.; Ethgen, Olivier ULg et al

in Annals of the Rheumatic Diseases (2005), 64(5), 688-693

OBJECTIVES: To capture changes in the quality of life (QoL) occurring in patients with osteoarthritis (OA) during treatment with non-specific non-steroidal anti-inflammatory drugs (NSAIDs) and to identify ... [more ▼]

OBJECTIVES: To capture changes in the quality of life (QoL) occurring in patients with osteoarthritis (OA) during treatment with non-specific non-steroidal anti-inflammatory drugs (NSAIDs) and to identify factors that predict such changes. METHODS: A naturalistic, prospective follow up of 783 patients with OA in whom primary care physicians decided to start treatment with non-selective NSAIDs. Short Form-36 (SF-36) and the Western Ontario and McMaster Universities OA index (WOMAC) were assessed at baseline and after 3 months. Baseline results were compared with QoL values in 4800 subjects randomly selected from the general population. Multiple regression analysis was performed to identify determinants of QoL at baseline and measures influencing changes in SF-36 or WOMAC during follow up. RESULTS: All QoL dimensions were significantly (p<0.01) decreased in patients with OA compared with controls. Significant improvement (p<0.05) in four dimensions of the SF-36 (vitality, role emotional, role physical, bodily pain) and in all components of the WOMAC was seen between baseline and month 3. Older age, female sex, longer duration of OA, and a higher number of comorbidities were the major determinants of a poor QoL at baseline. Maximal benefit from non-specific NSAIDs was seen in patients with the most severe impairment in QoL and the shortest duration of OA. CONCLUSION: OA negatively impacts all dimensions of the QoL. Non-specific NSAIDs improve the QoL in patients with OA treated in a "real life setting". The profile of patients receiving maximal benefit from such treatment may be of interest for health providers, enabling them to decide who should preferentially be given cytoprotective treatments or coxibs. [less ▲]

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See detailHealth-related quality of life as a predictor of direct costs in osteoarthritis
Ethgen, Olivier ULg; Richy, Florent; Cools, P. et al

in Osteoporosis International (2005, March), 16(Suppl.3), 59

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See detailPhysical functionning is the most severely affected health-related quality of life dimension during the aging process
Ethgen, Olivier ULg; Gosset, Christiane ULg; De Maeseneer, J. et al

in Osteoporosis International (2005, March), 16(Suppl.3), 25-26

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See detailAge- and sex-stratified prevalence of physical disabilities and handicap in the general population
Ethgen, Olivier ULg; GILLAIN, Daniel ULg; Gillet, Pierre ULg et al

in Osteoporosis International (2005, March), 16(Suppl.3), 25

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See detailScreening for osteoporosis: systematic DXA or pre-screening with questionnaires? An economic point of view
Richy, Florent; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Osteoporosis International (2005, March), 16(Suppl.3), 101

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See detailAn indirect comparison of the efficacies of vitamin D and its hydroxylated analogs in postmenopausal and corticosteroid-induced osteoporosis
Richy, Florent; Schacht, E.; Bruyère, Olivier ULg et al

in Osteoporosis International (2005, March), 16(Suppl.3), 29

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See detailVitamin D analogs versus native vitamin D in preventing bone loss and osteoporosis-related fractures: A comparative meta-analysis
Richy, F.; Schacht, E.; Bruyère, Olivier ULg et al

in Calcified Tissue International (2005), 76(3), 176-186

It has been suggested that early postmenopausal women and patients treated with steroids should receive preventive therapy (calcium, vitamin D, vitamin D analogs, estrogens, or bisphosphonates) to ... [more ▼]

It has been suggested that early postmenopausal women and patients treated with steroids should receive preventive therapy (calcium, vitamin D, vitamin D analogs, estrogens, or bisphosphonates) to preserve their bone mineral density (BMD) and to avoid fragility fractures. We designed the present study to compare the effects of native vitamin D to its hydroxylated analogs alfacalcidol 1-alpha(OH)D and calcitriol 1,25(OH)(2)D. All randomized, controlled, double-blinded trials comparing oral native vitamin D and its analogs, alfacalcidol or calcitriol, to placebo or head-to-head trials in primary or corticosteroids-induced osteoporosis were included in the meta-analysis. Sources included the Cochrane Controlled Trials Register, EMBASE, MEDLINE, and a hand search of abstracts and references lists. The study period January 1985 to January 2003. Data were abstracted by two investigators, and methodological quality was assessed in a similar manner. Heterogeneity was extensively investigated. Results were expressed as effect-size (ES) for bone loss and as rate difference (RD) for fracture while allocated to active treatment or control. Publication bias was investigated. Fourteen studies of native vitamin D, nine of alfacalcidol, and ten of calcitriol fit the inclusion criteria. The two vitamin D analogs appeared to exert a higher preventive effect on bone loss and fracture rates in patients not exposed to glucocorticoids. With respect to BMD, vitamin D analogs versus placebo studies had an ES of 0.36 (P < 0.0001), whereas native vitamin D versus placebo had an ES of 0.17 (P = 0.0005), the interclass difference being highly significant (ANOVA-1, P < 0.05). When restricted to the lumbar spine, this intertreatment difference remained significant: ES = 0.43 (P = 0.0002) for vitamin D analogs and ES = 0.21 (P = 0.001) for native vitamin D (analysis of variance [ANOVA-1], P = 0.047). There were no significant differences regarding their efficacies on other measurement sites (ANOVA-1, P = 0.36). When comparing the adjusted global relative risks for fracture when allocated to vitamin D analogs or native vitamin D, alfacalcidol and calcitriol provided a more marked preventive efficacy against fractures: RD = 10% (95% Confidence interval [CI-2] to 17) compared to RD = 2% (95% CI, 1 to 2), respectively. The analysis of the spinal and nonspinal showed that fracture rates differed between the two classes, thereby confirming the benefits of vitamin D analogs, with significant 13.4% (95% CI 7.7 to 19.8) and. 6% (95% CI 1 to 12) lower fracture rates for vitamin D analogs, respectively. In patients receiving corticosteroid therapy, both treatments provided similar global ESs for BMD: ES = 0.38 for vitamin D analogs and ES = 0.41 for native vitamin D (ANOVA-1, P = 0.88). When restriced to spinal BMD, D analogs provided significant effects, whereas native vitamin D did not: ES = 0.43 (P < 0.0001) and ES = 0.33 (P = 0.21), respectively. The intertreatment difference was nonsignificant (ANOVA-1, P = 0.52). Neither D analogs for native vitamin D significantly prevented fractures in this subcategory of patients: RD = 2.6 (95%CI, -9.5 to 4.3) and RD = 6.4 (95%CI, -2.3 to 10), respectively. In head-to-head studies comparing D analogs and native vitamin D in patients receiving corticosteroids, significant effects favoring D analogs were found for femoral neck BMD: ES = 0.31 at P = 0.02 and spinal fractures: RD = 15% (95%CI, 6.5 to 25). Publication bias was not significant. Our analysis demonstrates a superiority of the D analogs atfacalcidol and calcitriol in preventing bone loss and spinal fractures in primary osteoporosis, including postmenopausal women. In corticosteroid-induced osteoporosis, the efficacy of D analogs differed depending on the comparative approach: indirect comparisons led to nonsignificant differences, whereas direct comparison did provide significant differences. In this setting, D analogs seem to prevent spinal fractures to a greater extent than do native vitamin D, but this assumption should be confirmed on a comprehensive basis in multiarm studies including an inactive comparator. [less ▲]

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See detailControlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents
Bruyère, Olivier ULg; Wuidart, M. A.; Di Palma, E. et al

in Archives of Physical Medicine & Rehabilitation (2005), 86(2), 303-307

Objective: To investigate the effects of whole body vibration in the elderly. Design: Randomized controlled trial. Setting: Nursing home. Participants: Forty-two elderly volunteers. Interventions: Six ... [more ▼]

Objective: To investigate the effects of whole body vibration in the elderly. Design: Randomized controlled trial. Setting: Nursing home. Participants: Forty-two elderly volunteers. Interventions: Six-week vibration intervention plus physical therapy (PT) (n=22) or PT alone (n=20). Main Outcome Measures: We assessed gait and body balance using the Tinetti test (maximum scores of 12 for gait, 16 for body balance, 28 for global score), motor capacity using the Timed Up & Go (TUG) test, and health-related quality of life (HRQOL) using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results: After 6 weeks, the vibration intervention group improved by a mean +/- standard deviation of 2.4 +/- 2.3 points on the gait score compared with no score change in the control group (P<.001). The intervention group improved by 3.5 +/- 2.1 points on the body balance score compared with a decrease of 03 +/- 1.2 points in the control group (P<.001). TUG test time decreased by 11.0 +/- 8.6 seconds in the treated group compared with an increase of 2.6 +/- 8.8 seconds in the control group (P<.001). The intervention group had significantly greater improvements from baseline on 8 of 9 items on the SF-36 compared with the control group. Conclusions: Controlled whole body vibration can improve elements of fall risk and HRQOL in elderly patients. [less ▲]

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See detailPrimary prevention of osteoporosis: Mass screening scenario or prescreening with questionnaires? An economic perspective
Richy, F.; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Journal of Bone and Mineral Research (2004), 19(12), 1955-1960

This study focuses on the controversy surrounding selective approaches to screen for osteoporosis. Seven screening approaches were compared in terms of cost-effectiveness and incremental cost ... [more ▼]

This study focuses on the controversy surrounding selective approaches to screen for osteoporosis. Seven screening approaches were compared in terms of cost-effectiveness and incremental cost-effectiveness ratios in a sample of 4035 postmenopausal women. Our results show that certain prescreening strategies are more efficient than DXA-based approaches. These results are of considerable value for health policy decision-makers and the scientific community. [less ▲]

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