The Study of Osteoporotic Fractures Research Group:
Defining Incident Vertebral Deformity: A Prospective Comparison of Several Approaches
Article first published online: 1 JAN 1999
Copyright © 1999 ASBMR
Journal of Bone and Mineral Research
Volume 14, Issue 1, pages 90–101, January 1999
How to Cite
Black, D. M., Palermo, L., Nevitt, M. C., Genant, H. K., Christensen, L. and Cummings, S. R. (1999), Defining Incident Vertebral Deformity: A Prospective Comparison of Several Approaches. J Bone Miner Res, 14: 90–101. doi: 10.1359/jbmr.19184.108.40.206
University of California, San Francisco (Coordinating Center): S.R. Cummings (principal investigator), D.M. Black (coinvestigator, study statistician), M.C. Nevitt (coinvestigator), D.G. Seeley (project director), H.K. Genant (director, central radiology laboratory), C. Arnaud, D. Bauer, W. Browner, L. Christianson, M. Dockrell, C. Fox, C. Glüer, S. Harvey, M. Jergas, Mario Jaime-Chavez, R. Lipschutz, G. Milani, L. Palermo, A. Pressman, R. San Valentin, K. Stone, H. Tabor, D. Tanaka, and C. Yeung.
University of Maryland: J.C. Scott (principal investigator), R. Sherwin (coprincipal investigator), M.C. Hochberg (coinvestigator), J. Lewis (project director), Cheryl Bailey, (clinic coordinator), A. Bauer, L. Finazzo, G. Greenberg, D. Harris, B. Hohman, S. Kallenberger, E. Oliner, T. Page, A. Pettit, S. Snyder, L. Stranovsky, and S. Trusty.
University of Minnesota: K. Ensrud (principal investigator), R. Grimm Jr. (coinvestigator), C. Bell (project director), E. Mitson (clinic coordinator), M. Baumhover, C. Berger, S. Estill, S. Fillhouer, J. Hansen, K. Jacobson, K. Kiel, C. Linville, N. Nelson, E. Penland-Miller, and Jayne Griffith.
University of Pittsburgh: J.A. Cauley (principal investigator), L.H. Kuller (coprincipal investigator), M. Vogt (coinvestigator), L. Harper (project director), L. Buck (clinic coordinator), C. Bashada, A. Githens, A. McCune, D. Medve, M. Nasim, C. Newman, S. Rudovsky, N. Watson, and J. Carothers.
The Kaiser Permanente Center for Health Research, Portland, Oregon: T.M. Vogt (principal investigator), W.M. Vollmer, E. Orwoll, H. Nelson (coinvestigators), J. Blank (project director), S. Craddick (clinic coordinator), R. Bright, J. Wallace, F. Heinith, K. Moore, K. Redden, C. Romero, and C. Souvanlasy
- Issue published online: 2 DEC 2009
- Article first published online: 1 JAN 1999
- Manuscript Accepted: 24 AUG 1998
- Manuscript Revised: 14 AUG 1998
- Manuscript Received: 13 FEB 1998
Vertebral deformities are common and important outcomes in clinical trials and epidemiologic studies of osteoporosis. While several different methods for defining new deformities have been proposed, it is not clear which is best. We used data from serial spine radiographs obtained an average of 3.7 years apart in 7238 women age ≥65 years from the Study of Osteoporotic Fractures to compare several approaches to defining new deformities by morphometry including a fixed percentage reduction in any vertebral height (FIXED%), a change in a summary spinal deformity index, a change in a vertebra from no prevalent deformity at baseline to a deformity at follow-up, as well as several variations of these methods. We compared results of each definition with several clinical correlates, including height loss, back pain, age, baseline bone mineral density, and the presence of a baseline deformity. We also estimated the sample size required for a clinical trial using various cut points. At a given level of incidence, all methods had similar relationships with each of the correlates. Given that similarity, the FIXED% method was simplest and needed no reference data. Using the FIXED% method, a 20–25% vertebral height reduction criterion for deformity maximized the power for a clinical trial. We conclude that all of the morphometric approaches to defining incident deformities have similar relationships to clinical correlates of vertebral deformity, but that use of a fixed percentage reduction in vertebral height is the simplest and most practical. For the FIXED% method, a 20–25% reduction in vertebral height minimizes the sample size required for clinical trials and epidemiologic studies.