Browsing by Author "Carey J.J."

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    Asia–Pacific consensus for the management of osteoporosis in men
    (2025-01-01) Huang C.F.; Ho C.J.; Lin S.Y.; Hwang J.S.; Tai T.W.; Chen J.F.; Tu S.T.; Chan D.C.; Yang R.S.; Chen H.Y.; Tsai K.S.; Cheng T.T.; Chen F.P.; Hung W.C.; Chang Y.F.; Han D.S.; Chandran M.; Bin A.S.; Lee J.K.; Yeap S.S.; Chung Y.S.; Kim K.K.; Ebeling P.; Jaisamrarn U.; Pandey D.; Ferrari S.; McCloskey E.; Charatcharoenwitthaya N.; Taguchi A.; Lekamwasam S.; Van Nguyen T.; Lewiecki E.M.; Saag K.G.; Tsai C.C.; Marín F.; Mori S.; Hwang K.R.; Li-Yu J.; Carey J.J.; Kendler D.; Cheung C.L.; Huang H.K.; Kuptniratsaikul V.; Chan W.P.; Chan S.P.; Ho-Pham L.T.; Hew F.L.; Shi H.; Reid I.; Kanis J.A.; Chen C.H.; Wu C.H.; Huang C.F.; Mahidol University
    Summary: Osteoporosis in men is an underdiagnosed and undertreated condition that leads to significant morbidity and mortality, particularly in the aging population. This consensus report provides tailored guidelines for diagnosing, preventing, and treating male osteoporosis in the Asia–Pacific region by integrating global best practices with regional adaptations. Purpose: To establish evidence-based, region-specific guidelines for the management of male osteoporosis in the Asia–Pacific region, addressing demographic and lifestyle factors. Methods: Expert feedback was gathered through premeeting reviews, consensus conferences, and collaborative discussions. A life-course approach was employed to align international best practices with Asia–Pacific-specific needs, emphasizing continuous monitoring and intervention from middle age onward. Results: The 12 consensus strategies systematically approach male osteoporosis management, addressing screening, diagnosis, treatment, and long-term follow-up. Recommendations include the assessment of fracture risk for men aged 50 years and above, use of dual-energy X-ray absorptiometry (DXA) testing for men aged 70 years and above, lifestyle modifications, and pharmacological interventions such as bisphosphonates, denosumab, and anabolic agents for high-risk patients. Secondary causes of osteoporosis were highlighted, along with the establishment of fracture liaison services (FLSs) to improve long-term care. A life-course approach was proposed to optimize bone health throughout men’s lives. Conclusion: This consensus provides a comprehensive framework tailored to the Asia–Pacific region for diagnosing, preventing, and managing osteoporosis in men. By addressing region-specific challenges and promoting evidence-based interventions, the latest guidelines incorporating the consensus may depict the conceptual direction in reducing fracture risk and improving long-term bone health outcomes for osteoporosis in men.
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    Consensus statement on the application of artificial intelligence in osteoporosis screening and management: perspectives from the Asia-Pacific region
    (2026-01-01) Huang C.F.; Fang W.H.; Chen K.H.; Lin S.Y.; Ho C.J.; Hwang J.S.; Tai T.W.; Liu Y.F.; Shih C.A.; Chen J.F.; Tu S.T.; Chan D.C.; Yang R.S.; Fu S.H.; Chen H.Y.; Tsai K.S.; Cheng T.T.; Chen F.P.; Hung W.C.; Chang Y.F.; Han D.S.; Chandran M.; Bin A.S.; Lee J.K.; Yeap S.S.; Chung Y.S.; Kim K.K.; Ebeling P.R.; Jaisamrarn U.; Pandey D.; Ferrari S.; Yang T.H.; Charatcharoenwitthaya N.; Taguchi A.; Lekamwasam S.; Van Nguyen T.; Lewiecki E.M.; Saag K.G.; Tsai C.C.; Marín F.; Mori S.; Hwang K.R.; Li-Yu J.; Carey J.J.; Kendler D.; Cheung C.L.; Huang H.K.; Kuptniratsaikul V.; Chan W.P.; Chan S.P.; Ho-Pham L.T.; Hew F.L.; Shi H.; Rhee Y.; McCloskey E.; Tanaka S.; Hans D.; Kanis J.A.; Chen C.H.; Wu C.H.; Huang C.F.; Mahidol University
    Summary: Osteoporosis is a major and growing health concern in the Asia-Pacific region, y et it remains widely underdiagnosed and undertreated due to limited access to dual-energy X-ray absorptiometry (DXA) in many areas. Artificial intelligence (AI) offers new opportunities to improve osteoporosis screening and management, but unvalidated tools pose risks of inconsistent care. This consensus was developed to provide regionally harmonized guidance on the safe, effective, and equitable use of AI in osteoporosis care. Purpose: The aim of this work was to establish expert consensus recommendations on the role of AI in osteoporosis screening and management in the Asia-Pacific region. Key objectives were to define appropriate applications of AI (e.g., imaging-based bone assessment and fracture risk prediction) and specify minimum standards for validation and reporting, addressing region-specific implementation challenges and ensuring that AI use aligns with clinical guidelines and ethical principles. Methods: This consensus was developed through multidisciplinary collaboration among experts across the Asia-Pacific region. Each participant reviewed draft statements, contributed feedback during virtual meetings, and provided insights based on clinical experience and current evidence. Consensus was reached iteratively until full agreement was achieved for all statements. The process integrated global best practices and regional adaptations, drawing from peer-reviewed studies, international AI guidelines, and local fracture registry data. The final recommendations emphasize the validation, transparency, and ethical implementation of AI within regional healthcare systems, ensuring compatibility with local regulations. Ultimately, twelve consensus statements were established to guide the responsible use of AI for osteoporosis screening and management in the Asia-Pacific region. Results: The panel produced 12 consensus statements covering the role of AI as an adjunct for opportunistic osteoporosis screening rather than a diagnostic tool, requirements for imaging quality and AI model transparency, standards for validation and performance reporting, integration of AI with clinical risk stratification, demonstration of clinical utility in real-world settings, adherence to data protection laws and ethical AI principles, training of clinicians in AI use, strategies for implementation and monitoring (including post-market surveillance and feedback loops), and recognition of technical, clinical, and equity limitations of AI. All 12 statements give extensive recommendations for using AI to improve osteoporosis management while ensuring patient safety, accuracy, and equity. Conclusion: This first Asia-Pacific consensus on AI in osteoporosis concludes that AI, when appropriately validated and implemented, can help bridge the osteoporosis care gap by identifying high-risk patients who would otherwise remain undiagnosed, thus facilitating earlier intervention. It emphasizes that AI should complement—not replace—standard diagnostic methods and clinical judgment. The guidance emphasizes validation, transparency, and ethical oversight to facilitate early intervention while minimizing risks associated with unvalidated or premature AI adoption.
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    Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group
    (2022-12-01) Chotiyarnwong P.; McCloskey E.V.; Harvey N.C.; Lorentzon M.; Prieto-Alhambra D.; Abrahamsen B.; Adachi J.D.; Borgström F.; Bruyere O.; Carey J.J.; Clark P.; Cooper C.; Curtis E.M.; Dennison E.; Diaz-Curiel M.; Dimai H.P.; Grigorie D.; Hiligsmann M.; Khashayar P.; Lewiecki E.M.; Lips P.; Lorenc R.S.; Ortolani S.; Papaioannou A.; Silverman S.; Sosa M.; Szulc P.; Ward K.A.; Yoshimura N.; Kanis J.A.; Mahidol University
    Summary: The IOF Epidemiology and Quality of Life Working Group has reviewed the potential role of population screening for high hip fracture risk against well-established criteria. The report concludes that such an approach should strongly be considered in many health care systems to reduce the burden of hip fractures. Introduction: The burden of long-term osteoporosis management falls on primary care in most healthcare systems. However, a wide and stable treatment gap exists in many such settings; most of which appears to be secondary to a lack of awareness of fracture risk. Screening is a public health measure for the purpose of identifying individuals who are likely to benefit from further investigations and/or treatment to reduce the risk of a disease or its complications. The purpose of this report was to review the evidence for a potential screening programme to identify postmenopausal women at increased risk of hip fracture. Methods: The approach took well-established criteria for the development of a screening program, adapted by the UK National Screening Committee, and sought the opinion of 20 members of the International Osteoporosis Foundation’s Working Group on Epidemiology and Quality of Life as to whether each criterion was met (yes, partial or no). For each criterion, the evidence base was then reviewed and summarized. Results and Conclusion: The report concludes that evidence supports the proposal that screening for high fracture risk in primary care should strongly be considered for incorporation into many health care systems to reduce the burden of fractures, particularly hip fractures. The key remaining hurdles to overcome are engagement with primary care healthcare professionals, and the implementation of systems that facilitate and maintain the screening program.
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    Population screening for fracture risk in postmenopausal women — a logical step in reducing the osteoporotic fracture burden?
    (2022-08-01) McCloskey E.V.; Chotiyarnwong P.; Harvey N.C.; Lorentzon M.; Kanis J.A.; Prieto-Alhambra D.; Abrahamsen B.; Adachi J.D.; Borgström F.; Bruyere O.; Carey J.J.; Clark P.; Cooper C.; Curtis E.M.; Dennison E.; Diaz-Curiel M.; Dimai H.P.; Grigorie D.; Hiligsmann M.; Khashayar P.; Lewiecki E.M.; Lips P.; Lorenc R.S.; Ortolani S.; Papaioannou A.; Silverman S.; Sosa M.; Szulc P.; Ward K.; Yoshimura N.; Mahidol University