{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:15:14Z","timestamp":1793502914716,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2008,10,1]],"date-time":"2008-10-01T00:00:00Z","timestamp":1222819200000},"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":[[2008,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Low radiation dose imaging of the lateral spine acquired with a bone densitometer for vertebral fracture assessment (VFA) has great potential for clinical use. We have undertaken an evaluation of VFA in a prospective population cohort of elderly women to examine the prevalence of vertebral fractures, their ability to predict incident fractures, and their use in targeting therapy. Women (n = 5157) \u226575 yr of age living in the general community in the United Kingdom underwent posteroanterior and lateral imaging of the spine (T4\u2013L4) with a densitometer (Hologic QDR4500A) at entry to a randomized, double-blind, controlled trial of 800 mg oral clodronate (Bonefos) or matching placebo daily over 3 yr. The women were identified from general practice registers and recruited by letter of invitation regardless of skeletal status. The proportion of vertebrae interpretable varied from 98.2% at T12 to 57.1% at T4, with &amp;gt;92% interpretable at levels between T8 and L3. As judged by BMD at the total hip, 19.6% of the women had osteoporosis, and the prevalence of vertebral fracture was 14.5%. Women with one or more vertebral fractures had a relative risk (RR) for incident osteoporotic fractures of 2.01 (95% CI, 1.64\u20132.47). The RR for hip fractures was 2.29 (95% CI, 1.63\u20133.21). After adjustment for age, femoral neck BMD, weight, and treatment, the RR was 1.50 (95% CI, 1.21\u20131.86) for osteoporotic fractures, with similar results for hip fractures (RR, 1.41; 95% CI, 0.99\u20132.02). For women with two or more vertebral fractures, the adjusted RRs were 1.97 (95% CI, 1.24\u20132.72) and 1.86 (95% CI, 1.14\u20133.03) for osteoporotic and hip fractures, respectively. We conclude that VFA can frequently detect vertebral fractures in a population cohort of elderly women. These fractures, like radiographic fractures, predict future clinical fractures independent of age, weight, and BMD. Having multiple vertebral fractures was associated with greater risk of incident osteoporotic fractures and hip fractures.<\/jats:p>","DOI":"10.1359\/jbmr.080515","type":"journal-article","created":{"date-parts":[[2008,5,27]],"date-time":"2008-05-27T11:19:48Z","timestamp":1211887188000},"page":"1561-1568","source":"Crossref","is-referenced-by-count":89,"title":["Vertebral Fracture Assessment (VFA) With a Densitometer Predicts Future Fractures in Elderly Women Unselected for Osteoporosis"],"prefix":"10.1093","volume":"23","author":[{"given":"Eugene V","family":"McCloskey","sequence":"first","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreekanth","family":"Vasireddy","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Threlkeld","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Eastaugh","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa","family":"Parry","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bonnet","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Beneton","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Kanis","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Charlesworth","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024020319485077800_bib1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/jbmr.5650070214","article-title":"Incidence of clinically diagnosed vertebral fractures: A population-based study in Rochester, Minnesota, 1985-1989","volume":"7","author":"Cooper","year":"1992","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib2","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":"2024020319485077800_bib3","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s001980050076","article-title":"Health impact associated with vertebral deformities: Results from the European Vertebral Osteoporosis Study (EVOS)","volume":"8","author":"Matthis","year":"1998","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib4","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s001980050210","article-title":"Quality of life in patients with vertebral fractures: Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis","volume":"10","author":"Lips","year":"1999","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib5","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1007\/s001980170015","article-title":"Impact of hip and vertebral fractures on quality-adjusted life years","volume":"12","author":"Tosteson","year":"2001","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib6","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1001\/archinte.159.11.1215","article-title":"Vertebral fractures and mortality in older women: A prospective study. Study of Osteoporotic Fractures Research Group","volume":"159","author":"Kado","year":"1999","journal-title":"Arch Intern Med"},{"key":"2024020319485077800_bib7","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1359\/jbmr.2003.18.7.1254","article-title":"Association between vertebral fracture and increased mortality in osteoporotic patients","volume":"18","author":"Jalava","year":"2003","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib8","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00198-004-1698-y","article-title":"Risedronate decreases fracture risk in patients selected solely on the basis of prior vertebral fracture","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib9","doi-asserted-by":"crossref","first-page":"343","DOI":"10.4065\/80.3.343","article-title":"Effect of alendronate on vertebral fracture risk in women with bone mineral density T scores of \u22121.6 to \u22122.5 at the femoral neck: The Fracture Intervention Trial","volume":"80","author":"Quandt","year":"2005","journal-title":"Mayo Clin Proc"},{"key":"2024020319485077800_bib10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00198-004-1688-0","article-title":"Cost-effectiveness of raloxifene in the UK: An economic evaluation based on the MORE study","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib11","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jocd.2005.11.004","article-title":"Cost-effectiveness of vertebral fracture assessment to detect prevalent vertebral deformity and select postmenopausal women with a femoral neck T-score&gt;-2.5 for alendronate therapy: A modeling study","volume":"9","author":"Schousboe","year":"2006","journal-title":"J Clin Densitom"},{"key":"2024020319485077800_bib12","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1007\/s00198-007-0349-5","article-title":"Cost-effectiveness of alendronate in the treatment of postmenopausal women in 9 European countries\u2014an economic evaluation based on the fracture intervention trial","volume":"18","author":"Strom","year":"2007","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib13","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1385\/JCD:3:3:281","article-title":"Vertebral fractures in osteoporosis: A new method for clinical assessment","volume":"3","author":"Genant","year":"2000","journal-title":"J Clin Densitom"},{"key":"2024020319485077800_bib14","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/s001980070063","article-title":"Visual assessment of vertebral deformity by X-ray absorptiometry: A highly predictive method to exclude vertebral deformity","volume":"11","author":"Rea","year":"2000","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib15","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00198-005-2010-5","article-title":"Reliability and accuracy of vertebral fracture assessment with densitometry compared to radiography in clinical practice","volume":"17","author":"Schousboe","year":"2006","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib16","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s00198-006-0121-2","article-title":"Effectiveness of instant vertebral assessment to detect prevalent vertebral fracture","volume":"17","author":"Chapurlat","year":"2006","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jocd.2005.11.002","article-title":"Diagnosis of vertebral fractures by vertebral fracture assessment","volume":"9","author":"Damiano","year":"2006","journal-title":"J Clin Densitom"},{"key":"2024020319485077800_bib18","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1359\/jbmr.061008","article-title":"Clodronate reduces the incidence of fractures in community-dwelling elderly women unselected for osteoporosis: Results of a double-blind, placebo-controlled randomized study","volume":"22","author":"McCloskey","year":"2007","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib19","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/01.MLR.0000044901.57067.19","article-title":"Measuring population health: A comparison of three generic health status measures","volume":"41","author":"Macran","year":"2003","journal-title":"Med Care"},{"key":"2024020319485077800_bib20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/BF02672516","article-title":"Optimizing data acquisition and analysis of morphometric X-ray absorptiometry","volume":"8","author":"Rea","year":"1998","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib21","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/BF01623271","article-title":"Prevalence and incidence of vertebral deformities","volume":"3","author":"Melton","year":"1993","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib22","volume-title":"Vertebral Fracture in Osteoporosis","author":"Genant","year":"1995"},{"key":"2024020319485077800_bib23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/BF01623275","article-title":"The assessment of vertebral deformity: A method for use in population studies and clinical trials","volume":"3","author":"McCloskey","year":"1993","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib24","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1359\/jbmr.2002.17.6.1051","article-title":"The incidence of vertebral fractures in men and women: The Rotterdam Study","volume":"17","author":"Van der Klift","year":"2002","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib25","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1359\/JBMR.040215","article-title":"Risk factors for incident vertebral fractures in men and women: The Rotterdam Study","volume":"19","author":"van der Klift","year":"2004","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib26","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1359\/jbmr.2002.17.12.2214","article-title":"The relationship between bone density and incident vertebral fracture in men and women","volume":"17","author":"O'Neill","year":"2002","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jocd.2006.05.006","article-title":"Vertebral fracture assessment: The 2005 ISCD Official Positions","volume":"9","author":"Vokes","year":"2006","journal-title":"J Clin Densitom"},{"key":"2024020319485077800_bib28","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00198-004-1626-1","article-title":"Comparison of methods for the visual identification of prevalent vertebral fracture in osteoporosis","volume":"15","author":"Jiang","year":"2004","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib29","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1002\/jbmr.5650110716","article-title":"Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group","volume":"11","author":"Genant","year":"1996","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib30","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1007\/s001980170046","article-title":"Comparison of four morphometric definitions and a semiquantitative consensus reading for assessing prevalent vertebral fractures","volume":"12","author":"Grados","year":"2001","journal-title":"Osteoporos Int"},{"key":"2024020319485077800_bib31","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1359\/jbmr.1999.14.5.821","article-title":"Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group","volume":"14","author":"Black","year":"1999","journal-title":"J Bone Miner Res"},{"key":"2024020319485077800_bib32","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s00198-006-0306-8","article-title":"Enhanced prediction of fracture risk combining vertebral fracture status and BMD","volume":"18","author":"Siris","year":"2007","journal-title":"Osteoporos Int"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1359%2Fjbmr.080515","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/23\/10\/1561\/56570099\/5650231005.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/23\/10\/1561\/56570099\/5650231005.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T10:51:04Z","timestamp":1710327064000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/23\/10\/1561-1568\/7599421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,10,1]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2009,12,4]]},"published-print":{"date-parts":[[2008,10,1]]}},"URL":"https:\/\/doi.org\/10.1359\/jbmr.080515","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1126966.581740","asserted-by":"object"}]},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2008,10,1]]},"published":{"date-parts":[[2008,10,1]]}}}