Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, People's Republic of China.
The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, People's Republic of China.
J Orthop Surg Res. 2023 Jan 30;18(1):70. doi: 10.1186/s13018-023-03546-6.
This study aims to develop nomogram models based on the speed of sound (SOS) measurements results along with demographic information to predict the risk of low bone strength (LBS) of radius appropriate to the Chinese population of a broad age spectrum.
A population-based cross-sectional study was conducted in 5 outpatient clinics located in Zhejiang, the southern part of China. A total of 38,699 participants from 2013 to 2017 were included. Baseline measurements included SOS of the distal radius and clinical risk factor evaluation. Logistic regression models were used to evaluate prognosis and identify independent predictive factors, which were then utilized to establish nomograms for predicting the low bone strength of radius. The discrimination and calibration of nomograms were validated using the calibration plots, the decision curve analysis (DCA), and the receiver operating characteristics curve (ROC).
A total of 19,845 of the 38,904 participants ranged in age from 10 to 88 years were selected in this process. LBP nomogram model 1 was constructed based on age, weight, height, BMI, and gender. LBP nomogram model 2 was constructed based on age, height, BMI, and gender. The AUCs for model 1 and model 2 were 0.838 (95% CI: 0.832-0.844) and 0.837 (95% CI: 0.831-0.843), respectively. High-quality calibration plots and DCA in nomogram models were noticed, indicated that the constructed nomogram models were clinically useful.
Our study demonstrates that the nomograms established in this study could effectively evaluate the high-risk population groups of distal radius fracture in China.
本研究旨在基于声速（SOS）测量结果以及人口统计学信息，建立适用于中国广泛年龄谱人群的桡骨低骨强度（LBS）风险预测的诺模图模型。
本研究采用基于人群的横断面研究，在中国南部浙江省的 5 家门诊进行。共纳入了 2013 年至 2017 年的 38699 名参与者。基线测量包括桡骨远端 SOS 和临床危险因素评估。采用 logistic 回归模型评估预后并确定独立预测因素，然后利用这些因素建立预测桡骨低骨强度的诺模图。通过校准图、决策曲线分析（DCA）和接收者操作特征曲线（ROC）验证诺模图的区分度和校准度。
在这一过程中，从 38904 名参与者中选择了年龄在 10 至 88 岁之间的 19845 名参与者。基于年龄、体重、身高、BMI 和性别构建了 LBP 诺模图模型 1；基于年龄、身高、BMI 和性别构建了 LBP 诺模图模型 2。模型 1 和模型 2 的 AUC 分别为 0.838（95%CI：0.832-0.844）和 0.837（95%CI：0.831-0.843）。诺模图模型中高质量的校准图和 DCA 表明，所构建的诺模图模型具有临床实用性。
本研究表明，本研究建立的诺模图可有效评估中国桡骨远端骨折的高危人群。
