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Adapted with permission of the publisher from Cummings SR, Bates D, Black DM. Clinical use of bone densitometry. JAMA 2002;286:1889-1897. ©American Medical Association

Adapted with permission of the publisher from Cummings SR, Bates D, Black DM. Clinical use of bone densitometry. JAMA 2002;286:1889-1897. ©American Medical Association time frame that is too long to be clinically useful. Experts have argued that most patients will not take a preventive medication over a lifetime. Therefore, looking at their risk over a shorter period of time better assesses their need for and potential benefit from an intervention. In response, 5- and 10-year fracture probabilities are beginning to appear. Using fracture and mortality data from Malmo, Sweden, Kanis et al. (15) determined the 10-year probability of global and site-specific fractures. Tables 10-6 through 10-9 reflect the 10-year probability of fracture based on the patient's age and femoral neck T-score. The femoral neck T-score was again based on NHANES III 1995 reference data for Caucasian women (14). The relative risk of fracture at the hip and proximal humerus used to calculate 10-year fracture probabilities was 2.6 per SD decline in bone density at the femoral neck. Relative risk per SD decline in femoral neck bone density for spine fracture was assumed to be 1.8, for forearm fracture, 1.4, and for global fracture, 1.6.

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