Abstract
Femoral neck fracture prediction is an important social and economic issue. The research compares two statistical methods for the classification of patients at risk for femoral neck fracture: multiple logistic regression and Bayes linear classifier. The two approaches are evaluated for their ability to separate femoral neck fractured patients from osteoporotic controls. In total, 272 Italian women are studied. Densitometric and geometric measurements are obtained from the proximal femur by dual energy X-ray absorptiometry. The performances of the two methods are evaluated by accuracy in the classification and receiver operating characteristic curves. The Bayes classifier achieves an accuracy approximately 1% higher than that of the multiple logistic regression. However, the performances of the two methods, evaluated by the area under the curves, are not statistically different. The study demonstrates that the Bayes linear classifier can be a valid alternative to multiple logistic regression in the classification of osteoporotic patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Armitage, P., andBerry, G. (1987): ‘Statistical methods in medical research’ (Blackwell Scientific Publications, Oxford, 1987)
Barbini, P., Cevenini, G., Rubegni, P., Massai, M. R., Flori, M. L., Carli, P., andAndreassi, L. (1998): ‘Instrumental measurement of skin colour and skin type as risk factors for melanoma: a statistical classification procedure’,Melanoma Res.,8, pp. 439–447
Bertani, A., Cappello, A., Benedetti, M. G., Simoncini, L., andCatani, F. (1999): ‘Flat foot functional evaluation using pattern recognition of ground reaction data’,Clin. Biomech.,14, pp. 484–493
Chevalley, T., Rizzoli, R., Nydegger, V., Slosman, D., Tkatch, L., Rapin, C. H., Vasey, H., andBonjour, J. P. (1991): ‘Preferential low bone mineral density of the femoral neck in patients with recent fracture of the proximal femur’,Osteoporosis Int.,1, pp. 147–154
Cooper, C., Barker, D., Morris, J., andBriggs, R. (1987): ‘Osteoporosis, fall, and age in fracture of the proximal femur’,Br. Med. J.,295, pp. 13–15
Cummings, S. R., Black, D. M., Nevitt, M. C., Browner, W., Cauley, J., Ensrud, K., Genant, H. K., Palermo, L., Ott, J., andVogt, T. M. (1993): ‘Bone density at various sites for prediction of hip fractures. The study of Osteoporotic Fractures Research Group’,Lancet,341, pp. 72–75
Cummings, S. R., Nevitt, M. C., Browner, W. S., Stone, K., Fox, K. M., Ensrud, K. E., Cauley, J. A., Black, D., andVogt, T. M. (1995): ‘Risk factors for hip fracture in white women’,New Engl. J. Med.,332, pp. 767–773
Duboeuf, F., Hott, A. M., Kotzki, P. O., Marcelli, C., Meunier, P. J., andDelmas, P. D. (1997): ‘Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: the EPIDOS study’,J. Bone Min. Res.,12, pp. 1895–1902
Faulkner, K. G., Cummings, S. R., Black, D., Palermo, L., Gluer, C. C., andGenant, H. K. (1993): ‘Simple measurement of femoral geometry predicts hip fracture: the study of the osteoporotic fractures’,J. Bone Min. Res.,8, pp. 1211–1217
Fukunaga, K. (1990): ‘Introduction to statistical pattern recognition’ (Academic Press, San Diego, Ca., USA, 1990)
Genant, H. K., Faulkner, K. G., Gluer, C. C., andEngelke, K. (1993): ‘Bone densitometry: current assessment’,Osteoporosis Int.,Suppl.1, pp. S91-S97
Gnudi, S., Ripamonti, C., Gualtieri, G., andMalavolta, N. (1999): ‘Geometry of proximal femur in the prediction of hip fracture in osteoporotic women’,Br. J. Radiol.,72, pp. 729–733
Hanley, J. A., andMcNeil, B. J. (1982): ‘The meaning and the use of the area under a receiver operating characteristics (ROC) curve’,Diagnos. Radiol.,143, pp. 29–36
Hanley, J. A., andMcNeil, B. J. (1983): ‘A method of comparing the areas under receiver operating characteristics curves derived from the same cases’,Radiology,148, pp. 839–843
Hodsman, A., Adachi, J., andOlszynski, W. (1996): ‘Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 6. Use of bisphosphonates in the treatment of osteoporosis’,CMAJ,155, pp. 945–948
Kanis, J. A. (1993): ‘The incidence of hip fracture in Europe’,Osteoporosis Int.,Supp. 1, pp. 10–15
Kanis, J. A., andMcCloskey, E. V. (1996): ‘Evaluation of the risk of hip fracture’,Bone,18, pp. 127S-132S
Kroonenberg, A., Hayes, W. C., andMcMahon, T. A. (1995). ‘Dynamic models for sideways falls from standing height’,J. Biomech. Eng.,117, pp. 309–318
Melton, L. J., Atkinson, E. J., O'Fallon, W. M., Wahner, H. W., andRiggs, B. L. (1993): ‘Long-term fracture prediction by bone mineral assessed at different skeletal sites’,J. Bone Min. Res.,10, pp. 1227–1233
Metz, C. E. (1978): ‘Basic principles of ROC analysis’,Semin. Nucl. Med.,8, pp. 283–298
Metz, C. E. (1989): ‘Some practical issues of experimental design and data analysis in radiological ROC studies’,Investig. Radiol.,24, pp. 234–245
Miller, C. W. (1978): ‘Survival and ambulation following hip fracture’,J. Bone Joint Surg. Am.,60, pp. 930–934
Nguyen, T., Sambrook, P., Kelly, P., Jones, G., Lord, S., Freund, J., andEisman, J. (1993): ‘Prediction of osteoporotic fractures by postural instability and bone density’,Br. Med. J.,307, pp. 1111–1115
Reid, I. (1997): ‘The management of osteoporosis’,Baillieres Clin. Endocrinol. Metab.,11, p. 63
Robinovitch, S. N., Hayes, W. C., andMcMahon, T. A. (1991): ‘Prediction of femoral impact forces in falls on the hip’,J. Biomech. Eng.,113, pp. 366–374
Russell, R., andRogers, M. (1999): ‘Bisphosphonates: from the laboratory to the clinic and back again’,Bone,25, pp. 97–106
Schutte, H. E. (1995): ‘Social and economic impact of osteoporosis. A review of the literature’,Eur. J. Radiol.,20, pp. 165–169
Singer, F., andMinoofar, P. (1995): ‘Bisphosphonates in the treatment of disorders of mineral metabolism’,Adv. Endocrinol. Metab.,6, pp. 259–288
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Testi, D., Cappello, A., Chiari, L. et al. Comparison of logistic and Bayesian classifiers for evaluating the risk of femoral neck fracture in osteoporotic patients. Med. Biol. Eng. Comput. 39, 633–637 (2001). https://doi.org/10.1007/BF02345434
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02345434