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This work was supported in part by a grant from the Societat Catalana de Reumatologia.

Analysis of institutional authors

Florez HCorresponding AuthorHernández-Rodríguez JAuthorMuxi AAuthorPrieto-González SAuthorCid McAuthorEspinosa GAuthorGomez-Puerta JaAuthorMonegal AAuthorGuañabens NAuthorPeris PMain author

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Article

Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis

Publicated to:Rheumatology. 59 (7): 1574-1580 - 2020-07-01 59(7), DOI: 10.1093/rheumatology/kez464

Authors: Florez, Helena; Hernandez-Rodriguez, Jose; Mux, Africa; Lluis Carrasco, Josep; Prieto-Gonzalez, Sergio; Cid, Maria Cinta; Espinosa, Gerard; Gomez-Puerta, Jose A; Monegal, Ana; Guanabens, Nuria; Peris, Pilar

Affiliations

Univ Barcelona, CIBERehd, IDIBAPS, Hosp Clin,Dept Rheumatol,Metab Bone Dis Unit, Barcelona, Spain - Author
Univ Barcelona, Dept Basic Clin Practice, Biostat, Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Dept Nucl Med, Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Dept Rheumatol, Villarroel 170, Barcelona 08036, Spain - Author
Univ Barcelona, IDIBAPS, Hosp Clin, Dept Autoimmune Dis, Barcelona, Spain - Author
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Abstract

To analyse the clinical utility of trabecular bone score (TBS) evaluation for fracture risk assessment in glucocorticoid (GC)-treated patients compared with BMD assessment.One hundred and twenty-seven patients on GC treatment were included [mean age 62 (18) years, 63% women] in this cross-sectional study. The medical history, anthropometric data, lumbar and femoral BMD (DXA) [considering osteoporosis (OP): T-score ?-2.5], TBS (considering degraded microarchitecture: <1.230) and dorsolumbar X-ray [to assess vertebral fractures (VF)] were evaluated. BMD and TBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were evaluated to determine the diagnostic accuracy of the two methods.All patients were receiving GC treatment for autoimmune diseases during 47.7 (68.9) months at a mean daily dose of 14.5 mg; 17% had VF, 28% any type of fragility fracture (VF + non-VF), 29% OP and 52% degraded microarchitecture. Degraded microarchitecture was significantly more frequent than densitometric OP in patients with VF (76% vs 38%) and with any fragility fracture (69% vs 36%). For VF, TBS and BMD sensitivity, specificity, PPV, and NPV were 0.76, 0.53, 0.25 and 0.92, and 0.38, 0.72, 0.22 and 0.85, respectively. Specificity increased to 0.89 for VF and 0.9 for any fragility fracture on combining BMD+TBS. TBS had better ability than BMD to discriminate between patients with fracture, especially VF (area under the curve = 0.73).TBS seems to have greater discriminative power than BMD for fracture risk assessment in GC-treated patients, confirming the utility of this method as a complementary tool in the diagnosis of GC-induced OP.© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Keywords

autoimmune diseasesbone microarchitecturebone mineral densitydiscriminatory abilityfracture riskmicroarchitectureprevalencequalityspinetbstherapytrabecular bone scorevertebral fractureswomenAbsorptiometry, photonAdultAgedAged, 80 and overAutoimmune diseasesBone densityBone microarchitectureBone mineral densityCancellous boneCross-sectional studiesDiscriminatory abilityFemaleFemurFracture riskGlucocorticoid-induced osteoporosisGlucocorticoidsHumansInternational societyLumbar vertebraeMaleMicroarchitectureMiddle agedOsteoporosisOsteoporotic fracturesPrevalenceQualityRisk assessmentSpinal fracturesSpineTbsTherapyTrabecular bone scoreVertebral fracturesWomen

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Rheumatology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 5/34, thus managing to position itself as a Q1 (Primer Cuartil), in the category Rheumatology.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 2.63. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 3.44 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 17.83 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-01, the following number of citations:

  • WoS: 49
  • Scopus: 56
  • Europe PMC: 38

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-01:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 53.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 53 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 16.6.
  • The number of mentions on the social network X (formerly Twitter): 16 (Altmetric).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Florez Enrich, Helena) and Last Author (Peris Bernal, Pilar).

the author responsible for correspondence tasks has been Florez Enrich, Helena.