Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region.
Chandran, M
Mitchell, PJ
Amphansap, T
Bhadada, SK
Chadha, M
Chan, D-C
Chung, Y-S
Ebeling, P
Gilchrist, N
Habib Khan, A
Halbout, P
Hew, FL
Lan, H-PT
Lau, TC
Lee, JK
Lekamwasam, S
Lyubomirsky, G
Mercado-Asis, LB
Mithal, A
Nguyen, TV
Pandey, D
Reid, IR
Suzuki, A
Chit, TT
Tiu, KL
Valleenukul, T
Yung, CK
Zhao, YL
Asia Pacific Consortium on Osteoporosis (APCO),
- Publisher:
- SPRINGER LONDON LTD
- Publication Type:
- Journal Article
- Citation:
- Osteoporos Int, 2021, 32, (7), pp. 1249-1275
- Issue Date:
- 2021-07
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Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework clinical standards of care for the screening, di.pdf | Published version | 694.47 kB | Adobe PDF |
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Chandran, M | |
dc.contributor.author | Mitchell, PJ | |
dc.contributor.author | Amphansap, T | |
dc.contributor.author | Bhadada, SK | |
dc.contributor.author | Chadha, M | |
dc.contributor.author | Chan, D-C | |
dc.contributor.author | Chung, Y-S | |
dc.contributor.author | Ebeling, P | |
dc.contributor.author | Gilchrist, N | |
dc.contributor.author | Habib Khan, A | |
dc.contributor.author | Halbout, P | |
dc.contributor.author | Hew, FL | |
dc.contributor.author | Lan, H-PT | |
dc.contributor.author | Lau, TC | |
dc.contributor.author | Lee, JK | |
dc.contributor.author | Lekamwasam, S | |
dc.contributor.author | Lyubomirsky, G | |
dc.contributor.author | Mercado-Asis, LB | |
dc.contributor.author | Mithal, A | |
dc.contributor.author | Nguyen, TV | |
dc.contributor.author | Pandey, D | |
dc.contributor.author | Reid, IR | |
dc.contributor.author | Suzuki, A | |
dc.contributor.author | Chit, TT | |
dc.contributor.author | Tiu, KL | |
dc.contributor.author | Valleenukul, T | |
dc.contributor.author | Yung, CK | |
dc.contributor.author | Zhao, YL | |
dc.contributor.author | Asia Pacific Consortium on Osteoporosis (APCO), | |
dc.date.accessioned | 2022-04-15T20:39:22Z | |
dc.date.available | 2020-11-11 | |
dc.date.available | 2022-04-15T20:39:22Z | |
dc.date.issued | 2021-07 | |
dc.identifier.citation | Osteoporos Int, 2021, 32, (7), pp. 1249-1275 | |
dc.identifier.issn | 0937-941X | |
dc.identifier.issn | 1433-2965 | |
dc.identifier.uri | http://hdl.handle.net/10453/156292 | |
dc.description.abstract | Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care. PURPOSE: Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development. METHODS: We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards. RESULTS: Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines. CONCLUSION: The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | SPRINGER LONDON LTD | |
dc.relation.ispartof | Osteoporos Int | |
dc.relation.isbasedon | 10.1007/s00198-020-05742-0 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 0903 Biomedical Engineering, 1103 Clinical Sciences, 1117 Public Health and Health Services | |
dc.subject.classification | Endocrinology & Metabolism | |
dc.subject.mesh | Asia | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Mass Screening | |
dc.subject.mesh | Osteoporosis | |
dc.subject.mesh | Spinal Fractures | |
dc.subject.mesh | Standard of Care | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Osteoporosis | |
dc.subject.mesh | Spinal Fractures | |
dc.subject.mesh | Mass Screening | |
dc.subject.mesh | Asia | |
dc.subject.mesh | Standard of Care | |
dc.title | Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region. | |
dc.type | Journal Article | |
utslib.citation.volume | 32 | |
utslib.location.activity | England | |
utslib.for | 0903 Biomedical Engineering | |
utslib.for | 1103 Clinical Sciences | |
utslib.for | 1117 Public Health and Health Services | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Engineering and Information Technology | |
pubs.organisational-group | /University of Technology Sydney/Strength - CHT - Health Technologies | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering | |
pubs.organisational-group | /University of Technology Sydney/Centre for Health Technologies (CHT) | |
utslib.copyright.status | closed_access | * |
dc.date.updated | 2022-04-15T20:39:19Z | |
pubs.issue | 7 | |
pubs.publication-status | Published | |
pubs.volume | 32 | |
utslib.citation.issue | 7 |
Abstract:
Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care. PURPOSE: Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development. METHODS: We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards. RESULTS: Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines. CONCLUSION: The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis.
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