Secondary Causes of Osteoporosis in Fracture Patients
Bibliographic record
Abstract
OBJECTIVE: Identification and treatment of osteoporosis in the fragility fracture population and interventions to reduce the risk of future fracture are improving in orthopaedic practice. This study investigated the prevalence of vitamin D insufficiency and deficiency and other secondary causes of low bone density in patients who have sustained a fragility fracture and were referred from fracture clinic to a metabolic bone disease clinic (MBDC) for further assessment. DESIGN: Retrospective chart audit. SETTING: University hospital fracture clinic. PATIENTS: Three hundred ninety-nine patients referred from the orthopaedic division to the MBDC over a 3-year period. INTERVENTION: A standardized chart audit form was developed, and electronic charts were retrospectively audited. MAIN OUTCOME MEASUREMENTS: Secondary causes of osteoporosis and routine blood test results. RESULTS: Three hundred eight of 399 patients had blood investigations completed. A total of 98 patients (32%) had 125 secondary causes of osteoporosis other than vitamin D deficiency or insufficiency recorded in their electronic chart, including medication use, premature ovarian failure, hypogonadism, smoking, excessive alcohol use, renal impairment, gastrointestinal conditions, and endocrine conditions. Mean serum vitamin D level was 69.0 nmol/L in 83 men and 75.4 nmol/L in 186 women. Serum vitamin D levels were deficient at ≤25 nmol/L in 7 patients, insufficient at 26-74 nmol/L in 137 patients, and sufficient at ≥75 nmol/L in 125 patients. Investigation of causes of secondary osteoporosis can inform and influence specific treatment regimens. CONCLUSIONS: More than one-half of patients sustaining a fragility fracture and referred to the MBDC were vitamin D insufficient or deficient, and nearly one-third had a secondary cause of osteoporosis other than vitamin D insufficiency/deficiency. A standardized list of blood and urine analyses and radiographs has been implemented for fragility fracture patients and selected other fracture patients who are undergoing investigation for osteoporosis. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".