Prospective comparative study of quantitative X-ray (QXR) versus dual energy X-ray absorptiometry to determine the performance of QXR as a predictor of bone health for adult patients in secondary care

ObjectivesTo evaluate a method of quantitative X-ray (QXR) for obtaining bone health information from standard radiographs aimed at identifying early signs of osteoporosis to enable improved referral and treatment. This QXR measurement is performed by postexposure analysis of standard radiographs, meaning bone health data can be acquired opportunistically, alongside routine imaging.DesignThe relationship between QXR and dual energy X-ray absorptiometry (DEXA) was demonstrated with a phantom study. A prospective clinical study was conducted to establish areal bone mineral density (aBMD) prediction model and a risk prediction model of a non-normal DEXA outcome. This was then extrapolated to a larger patient group with DEXA referral data.SettingSecondary care National Health Service Hospital.Participants126 consenting adult patients from a DEXA clinic.InterventionsAll participants underwent a DEXA scan to determine BMD at the lumbar spine (L2–L4) and both hips. An additional Antero-Posterior pelvis X-ray on a Siemens Ysio, fixed digital radiograph system was performed for the study.OutcomePerformance of QXR as a risk predictor for non-normal (osteoporotic) BMD.ResultsInterim clinical study data from 78 patients confirmed a receiver operator curve (area under the ROC curve) of 0.893 (95% CI 0.843 to 0.942) for a risk prediction model of non-normal DEXA outcome. Extrapolation of these results to a larger patient group of 11 029 patients indicated a positive predictive value of 0.98 (sensitivity of 0.8) for a population of patients referred to DEXA under current clinical referral criteria.ConclusionsThis study confirms that the novel QXR method provides accurate prediction of a DEXA outcome.Trial registration numberISRCTN98160454; Pre-results.

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Bone health index by hand X-ray compared with bone mineral density by dual-energy X-ray absorptiometry in children with Duchenne muscular dystrophy

Bone Abstracts ◽

10.1530/boneabs.7.p91 ◽

2019 ◽

Author(s):

Jonathan J Bowden ◽

Ramkumar Krishnamurthy ◽

Houchun Hu ◽

Brent Adler ◽

Rajesh Krishnamurthy ◽

...

Keyword(s):

Bone Mineral Density ◽

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Bone Mineral ◽

Bone Health ◽

Dual Energy ◽

Health Index ◽

Mineral Density ◽

X Ray ◽

Bone Health Index

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Development and Validation of a Risk Prediction Model for Patients with COVID-19 Using Linked Population Health Data (Preprint)

10.2196/preprints.35617 ◽

2021 ◽

Author(s):

Nikolaos Mastellos ◽

Richard Betteridge ◽

Prasanth Peddaayyavarla ◽

Andrew Moran ◽

Jurgita Kaubryte ◽

...

Keyword(s):

Health Care ◽

Prediction Model ◽

Population Health ◽

Risk Prediction ◽

Validation Cohort ◽

Risk Prediction Model ◽

Adult Patients ◽

Internal Validation ◽

Temporal Validation ◽

Development And Validation

BACKGROUND The impact of the COVID-19 pandemic on health care utilisation and associated costs has been significant, with one in ten patients becoming severely ill and being admitted to hospital with serious complications during the first wave of the pandemic. Risk prediction models can help health care providers identify high-risk patients in their populations and intervene to improve health outcomes and reduce associated costs. OBJECTIVE To develop and validate a hospitalisation risk prediction model for adult patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). METHODS The model was developed using pre-linked and standardised data of adult patients with laboratory confirmed SARS-CoV-2 from Cerner’s population health management platform (HealtheIntent®) in the London Borough of Lewisham. A total of 14,203 patients who tested positive for SARS-CoV-2 between 1st March 2020 and 28th February 2021 were included in the development and internal validation cohorts. A second temporal validation cohort covered the period between 1st March 2021 to 30th April 2021. The outcome variable was hospital admission in adult patients with laboratory confirmed SARS-CoV-2. A generalised linear model was used to train the model. The predictive performance of the model was assessed using the area under the receiver operator characteristic curve (ROC-AUC). RESULTS Overall, 14,203 patients were included. Of those, 9,755 (68.7%) were assigned to the development cohort, 2,438 (17.2%) to the internal validation cohort, and 2,010 (14.1%) to the temporal validation cohort. A total of 917 (9.4%) patients were admitted to hospital in the development cohort, 210 (8.6%) in the internal validation cohort, and a further 204 (10.1%) in the temporal validation cohort. The model had a ROC-AUC of 0.85 in both the development and validation cohorts. The most predictive factors were older age, male sex, Asian or Other ethnic minority background, obesity, chronic kidney disease, hypertension and diabetes. CONCLUSIONS The COVID-19 hospitalisation risk prediction model demonstrated very good performance and can be used to stratify risk in the Lewisham population to help providers reduce unnecessary hospital admissions and associated costs, improve patient outcomes, and target those at greatest risk to ensure full vaccination against SARS-CoV-2. Further research may examine the external validity of the model in other populations.

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Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study

Pediatric Exercise Science ◽

10.1123/pes.2017-0217 ◽

2018 ◽

Vol 30 (4) ◽

pp. 466-473 ◽

Cited By ~ 6

Author(s):

Ana Torres-Costoso ◽

Dimitris Vlachopoulos ◽

Esther Ubago-Guisado ◽

Asunción Ferri-Morales ◽

Iván Cavero-Redondo ◽

...

Keyword(s):

Quantitative Ultrasound ◽

Bone Health ◽

Intraclass Correlation ◽

Broadband Ultrasound Attenuation ◽

Correlation Coefficients ◽

Dual Energy ◽

Stiffness Index ◽

X Ray ◽

Intraclass Correlation Coefficients ◽

Bivariate Correlation

Purpose: The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. Methods: In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12–14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland–Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. Results: Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43–.52; broadband ultrasound attenuation: r = .50–.58; speed of sound: r = .25–.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60–.68) between DXA and QUS to assess bone health. The Bland–Altman analysis showed a limited percentage of outliers (3.2%–8.6%). Conclusion: QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.

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Prediction of ventricular arrhythmias in patients with a spontaneous Brugada type 1 pattern: the key is in the electrocardiogram

EP Europace ◽

10.1093/europace/euz156 ◽

2019 ◽

Vol 21 (9) ◽

pp. 1400-1409 ◽

Cited By ~ 5

Author(s):

Antoine Delinière ◽

Adrian Baranchuk ◽

Joris Giai ◽

Francis Bessiere ◽

Delphine Maucort-Boulch ◽

...

Keyword(s):

Prediction Model ◽

Risk Prediction ◽

Univariate Analysis ◽

Sudden Cardiac Arrest ◽

International Study ◽

Risk Prediction Model ◽

Adult Patients ◽

Penalized Spline ◽

Model Based

Abstract Aims There is currently no reliable tool to quantify the risks of ventricular fibrillation or sudden cardiac arrest (VF/SCA) in patients with spontaneous Brugada type 1 pattern (BrT1). Previous studies showed that electrocardiographic (ECG) markers of depolarization or repolarization disorders might indicate elevated risk. We aimed to design a VF/SCA risk prediction model based on ECG analyses for adult patients with spontaneous BrT1. Methods and results This retrospective multicentre international study analysed ECG data from 115 patients (mean age 45.1 ± 12.8 years, 105 males) with spontaneous BrT1. Of these, 45 patients had experienced VF/SCA and 70 patients did not experience VF/SCA. Among 10 ECG markers, a univariate analysis showed significant associations between VF/SCA and maximum corrected Tpeak–Tend intervals ≥100 ms in precordial leads (LMaxTpec) (P < 0.001), BrT1 in a peripheral lead (pT1) (P = 0.004), early repolarization in inferolateral leads (ER) (P < 0.001), and QRS duration ≥120 ms in lead V2 (P = 0.002). The Cox multivariate analysis revealed four predictors of VF/SCA: the LMaxTpec [hazard ratio (HR) 8.3, 95% confidence interval (CI) 2.4–28.5; P < 0.001], LMaxTpec + ER (HR 14.9, 95% CI 4.2–53.1; P < 0.001), LMaxTpec + pT1 (HR 17.2, 95% CI 4.1–72; P < 0.001), and LMaxTpec + pT1 + ER (HR 23.5, 95% CI 6–93; P < 0.001). Our multidimensional penalized spline model predicted the 1-year risk of VF/SCA, based on age and these markers. Conclusion LMaxTpec and its association with pT1 and/or ER indicated elevated VF/SCA risk in adult patients with spontaneous BrT1. We successfully developed a simple risk prediction model based on age and these ECG markers.

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Bone health of children with intestinal failure measured by dual energy X-ray absorptiometry and digital X-ray radiogrammetry

Clinical Nutrition ◽

10.1016/j.clnu.2017.02.014 ◽

2018 ◽

Vol 37 (2) ◽

pp. 687-694 ◽

Cited By ~ 10

Author(s):

Esther Neelis ◽

Noortje Rijnen ◽

Johanna Sluimer ◽

Joanne Olieman ◽

Dimitris Rizopoulos ◽

...

Keyword(s):

Bone Health ◽

Intestinal Failure ◽

Dual Energy ◽

X Ray

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A LOCAL SURVEY AMONGST 92 PATIENTS WITH MULTIPLE SCLEROSIS: WHAT CAN WE LEARN ABOUT THIS POPULATION'S DISEASE MANAGEMENT? HOW SATISFIED ARE PATIENTS WITH OUR SERVICE?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.101 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.4-e4

Author(s):

James Bashford ◽

Eli Silber

Keyword(s):

Mental Health ◽

Bone Health ◽

Patient Management ◽

Symptom Burden ◽

Dual Energy ◽

Primary Data ◽

Patient Questionnaire ◽

Depression And Anxiety ◽

X Ray ◽

Anxiety Depression

In order to better inform local clinical practice, we collected primary data from our local MS population. We addressed important aspects concerning relapse management, bone health, mental health, sphincter dysfunction, symptom burden, recognition of comorbidities and pharmacological treatment. An emphasis was placed on discovering the extent of patient satisfaction with the local service.An 11-page patient questionnaire was distributed to consecutive consenting patients attending the MS clinic. A supplemental questionnaire was provided to those patients on regular natalizumab therapy. In total, 92 full and 22 natalizumab questionnaires were completed.Two particular areas highlighted for improvement with regards to patient management and patient education were bone and mental health:1. Only 26% of respondents confirmed having had a dual-energy X-ray absorptiometry (DEXA) scan. When asked if reduced ability in MS is an important risk factor for osteoporosis, only 44/92 patients confirmed they thought this was true.2. In the last year, 41% and 58% of respondents have suffered from depression and anxiety, respectively. Despite this, only a third of these patients received any treatment (pharmacological or non-pharmacological) for anxiety, depression or both.Encouragingly, 95% of those surveyed would recommend our MS service to a friend or family member.

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Dual Energy X-ray Absorptiometry Scanning and Bone Health: The Pressing Need to Raise Awareness Amongst Pakistani Women

Cureus ◽

10.7759/cureus.5724 ◽

2019 ◽

Author(s):

Farah Anwar ◽

Hiba Iftekhar ◽

Tasneem Taher ◽

Syeda K Kazmi ◽

Fatima Z Rehman ◽

...

Keyword(s):

Bone Health ◽

Dual Energy ◽

X Ray ◽

Pakistani Women

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High-resolution peripheral quantitative computed tomography in children with osteogenesis imperfecta

Pediatric Radiology ◽

10.1007/s00247-020-04736-8 ◽

2020 ◽

Vol 50 (12) ◽

pp. 1781-1787

Author(s):

David J. Fennimore ◽

Maria Digby ◽

Margaret Paggiosi ◽

Paul Arundel ◽

Nick J. Bishop ◽

...

Keyword(s):

High Resolution ◽

Osteogenesis Imperfecta ◽

Bone Health ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Dual Energy ◽

Clinical Implications ◽

Quantitative Ct ◽

Future Studies ◽

X Ray

Abstract Bone health in children with osteogenesis imperfecta is monitored using radiographs and dual-energy X-ray absorptiometry, which have limitations. High-resolution peripheral quantitative CT can non-invasively derive bone microarchitectural data. Children with severe osteogenesis imperfecta have fragile deformed bones, and positioning for this scan can be difficult. We assessed the feasibility of high-resolution peripheral quantitative CT in nine children aged 9–15 years with osteogenesis imperfecta and compared results with dual-energy X-ray absorptiometry and with healthy controls. All nine recruited children were successfully scanned and showed no preference for either modality. It therefore appears feasible to perform high-resolution peripheral quantitative CT in children with osteogenesis imperfecta aged 9 years and older. Future studies should focus on understanding the clinical implications of the technology in this patient cohort.

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