{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:09:59Z","timestamp":1791976199574,"version":"4.4.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2005,4,1]],"date-time":"2005-04-01T00:00:00Z","timestamp":1112313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate radiographic diagnosis of vertebral fractures is important. This multicenter, multinational study assessed radiographic diagnoses of vertebral fracture in 2451 postmenopausal women with osteoporosis. Comparison between local and central readings yielded a false-negative rate of 34%. Underdiagnosis of vertebral fracture is a worldwide problem.<\/jats:p>\n                  <jats:p>Introduction: Vertebral fractures are the most common complication of osteoporosis. Although they are associated with significant morbidity, they frequently do not come to clinical attention. Accurate radiographic diagnosis is important.<\/jats:p>\n                  <jats:p>Materials and Methods: In a multicenter, multinational prospective study (the IMPACT trial), the accuracy of radiographic diagnosis of vertebral fracture was evaluated in postmenopausal women 65\u201380 years of age newly diagnosed with osteoporosis (based on BMD measurement). Lateral radiographs of the thoracolumbar spine were evaluated for identification of vertebral fractures, first locally and subsequently at a central reading center, using a validated semiquantitative method. False-positive and false-negative rates were calculated based on adjudicated discrepancies between the initial interpretation at the local site and the subsequent central reading, considered the \u201creference standard.\u201d<\/jats:p>\n                  <jats:p>Results: Of 2451 women with an evaluable radiograph both centrally and locally, 789 (32%) had at least one vertebral fracture. Adjudicated discrepancies (n = 350 patients) between local and central readings because of undetected vertebral fracture (68%) or equivocal terminology in the local radiology report (32%) yielded a false-negative rate of 34%.<\/jats:p>\n                  <jats:p>Conclusions: Underdiagnosis of vertebral fractures was observed in all geographic regions (false-negative rates: North America, 45.2%; Latin America, 46.5%; Europe\/South Africa\/Australia, 29.5%). The false-positive rate was 5% globally. Underdiagnosis of vertebral fracture is a worldwide problem attributable in part to a lack of radiographic detection, use of ambiguous terminology in the radiology report, or both. Efforts to improve accuracy and reduce variability in terminology and interpretation may increase the effectiveness of spinal radiography for detecting vertebral fractures in patients with osteoporosis.<\/jats:p>","DOI":"10.1359\/jbmr.041214","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T03:54:53Z","timestamp":1146110093000},"page":"557-563","source":"Crossref","is-referenced-by-count":475,"title":["Underdiagnosis of Vertebral Fractures Is a Worldwide Problem: The IMPACT Study"],"prefix":"10.1093","volume":"20","author":[{"given":"Pierre D","family":"Delmas","sequence":"first","affiliation":[{"name":"INSERM Unit 403 and University Claude Bernard, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lex","family":"van de Langerijt","sequence":"additional","affiliation":[{"name":"Aventis, Bridgewater, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson B","family":"Watts","sequence":"additional","affiliation":[{"name":"Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Eastell","sequence":"additional","affiliation":[{"name":"Division of Clinical Sciences, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Genant","sequence":"additional","affiliation":[{"name":"University of California in San Francisco and SYNARC, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Grauer","sequence":"additional","affiliation":[{"name":"Procter & Gamble Pharmaceuticals, Mason, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L","family":"Cahall","sequence":"additional","affiliation":[{"name":"Aventis, Bridgewater, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024013019232346100_bib1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jbmr.5650060302","article-title":"Classification of vertebral fractures","volume":"6","author":"Eastell","year":"1991","journal-title":"J Bone Miner Res"},{"key":"2024013019232346100_bib2","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/jama.285.3.320","article-title":"Risk of new vertebral fracture in the year following a fracture","volume":"285","author":"Lindsay","year":"2001","journal-title":"JAMA"},{"key":"2024013019232346100_bib3","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1359\/jbmr.2000.15.4.721","article-title":"Patients with prior fractures have an increased risk of future fractures: A summary of the literature and statistical synthesis","volume":"15","author":"Klotzbuecher","year":"2000","journal-title":"J Bone Miner Res"},{"key":"2024013019232346100_bib4","doi-asserted-by":"crossref","first-page":"793","DOI":"10.7326\/0003-4819-128-10-199805150-00001","article-title":"The association of radiographically detected vertebral fractures with back pain and function: A prospective study","volume":"128","author":"Nevitt","year":"1998","journal-title":"Ann Intern Med"},{"key":"2024013019232346100_bib5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1001\/archinte.160.1.77","article-title":"Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures Fracture Intervention Trial Research Group","volume":"160","author":"Nevitt","year":"2000","journal-title":"Arch Intern Med"},{"key":"2024013019232346100_bib6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1532-5415.2000.tb02641.x","article-title":"Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass Fracture Intervention Trial Research Group","volume":"48","author":"Ensrud","year":"2000","journal-title":"J Am Geriatr Soc"},{"key":"2024013019232346100_bib7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/jbmr.5650070413","article-title":"Contribution of vertebral deformities to chronic back pain and disability. 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