***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: UNLABELLED Oral daily ( 2.5 mg ) and intermittent ib and ronate ( between-dose interval of > 2 months ) , delivering a similar cumulative exposure , were evaluated in 2946 osteoporotic women with prevalent vertebral fracture . Significant reduction in incident vertebral fracture risk by 62 % and 50 % , respectively , was shown after 3 years . This is the first study to prospect ively show antifracture efficacy for the intermittent administration of a bisphosphonate . INTRODUCTION Bisphosphonates are important therapeutics in postmenopausal osteoporosis . However , they are currently associated with stringent dosing instructions that may impair patient compliance and hence therapeutic efficacy . Less frequent , intermittent administration may help to overcome these deficiencies . This study assessed the efficacy and safety of oral ib and ronate administered either daily or intermittently with a dose-free interval of > 2 months . MATERIAL S AND METHODS This r and omized , double-blind , placebo-controlled , parallel-group study enrolled 2946 postmenopausal women with a BMD T score < or = -2.0 at the lumbar spine in at least one vertebra ( L1-L4 ) and one to four prevalent vertebral fractures ( T4-L4 ) . Patients received placebo or oral ib and ronate administered either daily ( 2.5 mg ) or intermittently ( 20 mg every other day for 12 doses every 3 months ) . RESULTS AND CONCLUSIONS After 3 years , the rate of new vertebral fractures was significantly reduced in patients receiving oral daily ( 4.7 % ) and intermittent ib and ronate ( 4.9 % ) , relative to placebo ( 9.6 % ) . Thus , daily and intermittent oral ib and ronate significantly reduced the risk of new morphometric vertebral fractures by 62 % ( p = 0.0001 ) and 50 % ( p = 0.0006 ) , respectively , versus placebo . Both treatment groups also produced a statistically significant relative risk reduction in clinical vertebral fractures ( 49 % and 48 % for daily and intermittent ib and ronate , respectively ) . Significant and progressive increases in lumbar spine ( 6.5 % , 5.7 % , and 1.3 % for daily ib and ronate , intermittent ib and ronate , and placebo , respectively , at 3 years ) and hip BMD , normalization of bone turnover , and significantly less height loss than in the placebo group were also observed for both ib and ronate regimens . The overall population was at low risk for osteoporotic fractures . Consequently , the incidence of nonvertebral fractures was similar between the ib and ronate and placebo groups after 3 years ( 9.1 % , 8.9 % , and 8.2 % in the daily , intermittent , and placebo groups , respectively ; difference between arms not significant ) . However , findings from a posthoc analysis showed that the daily regimen reduces the risk of nonvertebral fractures ( 69 % ; p = 0.012 ) in a higher-risk subgroup ( femoral neck BMD T score < -3.0 ) . In addition , oral ib and ronate was well tolerated . Oral ib and ronate , whether administered daily or intermittently with an extended between-dose interval of > 2 months , is highly effective in reducing the incidence of osteoporotic fractures in postmenopausal women . This is the first time that significant fracture efficacy has been prospect ively shown with an intermittently administered bisphosphonate in the overall study population of a r and omized , controlled clinical trial . Thus , oral ib and ronate holds promise as an effective and convenient alternative to current bisphosphonate therapies The purpose of this study was to determine the validity of the Osteoporosis Risk Assessment Instrument ( ORAI ) , Osteoporosis Self- Assessment Tool ( OST ) chart and equation , and a criterion based on body weight for identifying women with asymptomatic primary osteoporosis . Prospect i ve recruitment and chart abstract ions from family practice s of three University affiliated hospitals were completed for women aged 45 years or more with baseline bone mineral density ( BMD ) testing results by dual energy X-ray absorptiometry . Those taking bone active medication other than hormone therapy , with prior fragility fracture or with risk factors for secondary osteoporosis were excluded . Women were categorized as being normal , osteopenic or osteoporotic by lowest BMD T-score at either the femoral neck or lumbar spine ( L1–L4 ) . Sensitivity , specificity and area under the receiver operating characteristic ( ROC ) curve to identify those with osteoporosis were determined for each decision rule . The positive predictive value ( PPV ) for detecting osteoporosis after using a second cut point to convert each decision rule into a risk index ( low , moderate or high risk ) was also determined . The sensitivity of the decision rules to identify women with osteoporosis ranged from 92 % to 95 % and specificity from 35 % to 46 % . The area under the ROC curves were significantly better for the ORAI ( 0.80 ) , OST chart ( 0.82 ) and OST equation ( 0.82 ) compared with the body weight criterion ( 0.73 ) . PPV for detecting osteoporosis ranged from 30 % to 58 % among women deemed at high risk . These data confirm the validity of the ORAI , the OST chart and the OST equation as screening tools for BMD testing . Further evidence is required to confirm the validity of the body weight criterion BACKGROUND Risedronate increases bone mineral density in elderly women , but whether it prevents hip fracture is not known . METHODS We studied 5445 women 70 to 79 years old who had osteoporosis ( indicated by a T score for bone mineral density at the femoral neck that was more than 4 SD below the mean peak value in young adults [ -4 ] or lower than -3 plus a nonskeletal risk factor for hip fracture , such as poor gait or a propensity to fall ) and 3886 women at least 80 years old who had at least one nonskeletal risk factor for hip fracture or low bone mineral density at the femoral neck ( T score , lower than -4 or lower than -3 plus a hip-axis length of 11.1 cm or greater ) . The women were r and omly assigned to receive treatment with oral risedronate ( 2.5 or 5.0 mg daily ) or placebo for three years . The primary end point was the occurrence of hip fracture . RESULTS Overall , the incidence of hip fracture among all the women assigned to risedronate was 2.8 percent , as compared with 3.9 percent among those assigned to placebo ( relative risk , 0.7 ; 95 percent confidence interval , 0.6 to 0.9 ; P=0.02 ) . In the group of women with osteoporosis ( those 70 to 79 years old ) , the incidence of hip fracture among those assigned to risedronate was 1.9 percent , as compared with 3.2 percent among those assigned to placebo ( relative risk , 0.6 ; 95 percent confidence interval , 0.4 to 0.9 ; P=0.009 ) . In the group of women selected primarily on the basis of nonskeletal risk factors ( those at least 80 years of age ) , the incidence of hip fracture was 4.2 percent among those assigned to risedronate and 5.1 percent among those assigned to placebo ( P=0.35 ) . CONCLUSIONS Risedronate significantly reduces the risk of hip fracture among elderly women with confirmed osteoporosis but not among elderly women selected primarily on the basis of risk factors other than low bone mineral density BACKGROUND Strontium ranelate , a new oral drug shown to reduce vertebral fracture risk in postmenopausal women with osteoporosis , was studied in the Treatment of Peripheral Osteoporosis ( TROPOS ) study to assess its efficacy and safety in preventing nonvertebral fractures also . METHODS Strontium ranelate ( 2 g/d ) or placebo were r and omly allocated to 5091 postmenopausal women with osteoporosis in a double-blind  placebo-controlled 5-yr study with a main statistical analysis over 3 yr of treatment . FINDINGS In the entire sample , relative risk ( RR ) was reduced by 16 % for all nonvertebral fractures ( P = 0.04 ) , and by 19 % for major fragility fractures ( hip , wrist , pelvis and sacrum , ribs and sternum , clavicle , humerus ) ( P = 0.031 ) in strontium ranelate-treated patients in comparison with the placebo group . Among women at high risk of hip fracture ( age > or = 74 yr and femoral neck bone mineral density T score < or = -3 , corresponding to -2.4 according to NHANES reference ) ( n = 1977 ) , the RR reduction for hip fracture was 36 % ( P = 0.046 ) . RR of vertebral fractures was reduced by 39 % ( P < 0.001 ) in the 3640 patients with spinal x-rays and by 45 % in the subgroup without prevalent vertebral fracture . Strontium ranelate increased bone mineral density throughout the study , reaching at 3 yr ( P < 0.001 ) : + 8.2 % ( femoral neck ) and + 9.8 % ( total hip ) . Incidence of adverse events ( AEs ) was similar in both groups . CONCLUSION This study shows that strontium ranelate significantly reduces the risk of all nonvertebral and in a high-risk subgroup , hip fractures over a 3-yr period , and is well tolerated . It confirms that strontium ranelate reduces vertebral fractures .  Strontium ranelate offers a safe and effective means of reducing the risk of fracture associated with osteoporosis Bone mineral density ( BMD ) is the primary predictor of fracture , and is utilised in the definition of osteoporosis . Mass screening for osteoporosis is , however , currently not recommended . The primary objective of this study was to develop , vali date and assess a simple , non-invasive scoring system to identify women at high risk of fracture . Using baseline data of the Dubbo Osteoporosis Epidemiology Study , a sample of 1256 women aged 60 or above was r and omly divided into a development cohort ( n=846 ) and a validation cohort ( n=410 ) . Low BMD was evaluated by DXA , with respect to 2.0 or 2.5 SD below the mean for young normal women at the femoral neck and lumbar spine . A logistic regression model was used to derive a predictive score , “ DOEScore ” , in the development cohort , and the performance of this score was then assessed in the validation cohort . Incident fractures over 9395 person-years ( median of follow-up duration : 8.4 years ) were identified by X-ray records . Approximately 57 % and 40 % of women ( in both cohorts ) had T-scores less than −2.0 and greater than −2.5 , respectively . Only age , body weight , and previous fracture were significantly related to BMD at both the femoral neck and lumbar spine . These three variables were used in the development of the DOEScore . When applied to the validation cohort , the sensitivity and specificity of DOEScore were 0.82 and 0.52 , respectively , for selecting women with T-scores less than −2.5 ; the area under the receiver operating characteristic ( ROC ) curve was 0.75 . These goodness-of-fit indices were comparable to , or better than , those obtained by the FOSTA , SOFSURF and ORAI score systems . However , neither the DOEScore nor other score systems reliably identify women with incident fractures ; for DOEScore , the sensitivity and specificity were 0.52 and 0.49 , respectively , with an area under the ROC curve of 0.48 . Clinical risk scores can be used to identify women likely to have low BMD ( albeit with low specificity ) , but they are not a useful tool to identify women who will have a fracture CONTEXT Risedronate , a potent bisphosphonate , has been shown to be effective in the treatment of Paget disease of bone and other metabolic bone diseases but , to our knowledge , it has not been evaluated in the treatment of established postmenopausal osteoporosis . OBJECTIVE To test the efficacy and safety of daily treatment with risedronate to reduce the risk of vertebral and other fractures in postmenopausal women with established osteoporosis . DESIGN , SETTING , AND PARTICIPANTS R and omized , double-blind , placebo-controlled trial of 2458 ambulatory postmenopausal women younger than 85 years with at least 1 vertebral fracture at baseline who were enrolled at 1 of 110 centers in North America conducted between December 1993 and January 1998 . INTERVENTIONS Subjects were r and omly assigned to receive oral treatment for 3 years with risedronate ( 2.5 or 5 mg/d ) or placebo . All subjects received calcium , 1000 mg/d . Vitamin D ( cholecalciferol , up to 500 IU/d ) was provided if baseline levels of 25-hydroxyvitamin D were low . MAIN OUTCOME MEASURES Incidence of new vertebral fractures as detected by quantitative and semiqu 
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In comparative meta-analyses , we found that the accuracy of OST was similar to other tests that are based on information from the medical history .
By contrast , assessment by quantitative ultrasonography at the heel was more accurate than OST in discriminating between women with high and low BMD .
Conclusions In white women , the accuracy of OST and alternative clinical decision rules was similar , whereas Stiffness Index was more accurate than OST .