Summary: In the longitudinal, retrospective study, the ability of the FRAX, Garvan, and POL-RISK algorithms to predict osteoporotic fractures was compared in a group of 457 women. Using the rigid threshold of 10% showed a significant discrepancy in sensitivity and specificity of all tools. New thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds allow for improving the diagnostic accuracy of all three calculators. Introduction: The aim of the longitudinal, retrospective study was to compare three tools designed to assess fracture risk: FRAX, Garvan, and POL-RISK in their prediction of fracture incidence. Material: The study group consisted of 457 postmenopausal women with a mean age of 64.21 ± 5.94 years from the Gliwice Osteoporosis (GO) Study. Comprehensive data on clinical factors related to fractures were collected for all participants. Bone densitometry was performed at the proximal femur using the Prodigy device (GE, USA). Fracture risk was established using the FRAX, Garvan, and POL-RISK algorithms. Data on the incidence of osteoporotic fractures were collected over the last 10 years. Results: During the period of observation 72, osteoporotic fractures occurred in 63 subjects. For a preliminary comparison of the predictive value of analyzed diagnostic tools, the fracture risk threshold of 10% was used. For FRAX, the fracture probability exceeding 10% was observed only in 11 subjects who experienced fractures; thus, the fracture was properly predicted only in 22.9% of women. For Garvan, the respective value was 90.5%, and for POL-RISK, it was 98.4%. That gave a very low true positive value for FRAX and a very high false positive value for Garvan and POL-RISK. Based on ROC curves, new thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds improve the diagnostic accuracy of all compared fracture prediction tools. Conclusion: The current study showed that different fracture risk assessment tools, although having similar clinical purposes, require different cut-off thresholds for making therapeutic decisions. Better identification of patients requiring therapy based on such an approach may help reduce the number of new fractures.

In the DECODE project, data were collected from 3,114 surveys filled by symptomatic patients RT-qPCR tested for SARS-CoV-2 in a single university centre in March-September 2020. The population demonstrated balanced sex and age with 759 SARS-CoV-2( +) patients. The most discriminative symptoms in SARS-CoV-2( +) patients at early infection stage were loss of taste/smell (OR = 3.33,p < 0.0001), body temperature above 38℃ (OR = 1.67,p < 0.0001), muscle aches (OR = 1.30,p = 0.0242), headache (OR = 1.27,p = 0.0405), cough (OR = 1.26,p = 0.0477). Dyspnea was more often reported among SARS-CoV-2(-) (OR = 0.55,p < 0.0001). Cough and dyspnea were 3.5 times more frequent among SARS-CoV-2(-) (OR = 0.28,p < 0.0001). Co-occurrence of cough, muscle aches, headache, loss of taste/smell (OR = 4.72,p = 0.0015) appeared significant, although co-occurrence of two symptoms only, cough and loss of smell or taste, means OR = 2.49 (p < 0.0001). Temperature > 38℃ with cough was most frequent in men (20%), while loss of taste/smell with cough in women (17%). For younger people, taste/smell impairment is sufficient to characterise infection, whereas in older patients co-occurrence of fever and cough is necessary. The presented study objectifies the single symptoms and interactions significance in COVID-19 diagnoses and demonstrates diverse symptomatology in patient groups.

New diseases constantly endanger the lives of populations, and, nowadays, they can spread easily and constitute a global threat. The COVID-19 pandemic has shown that the fight against a new disease may be difficult, especially at the initial stage of the epidemic, when medical knowledge is not complete and the symptoms are ambiguous. The use of machine learning tools can help to filter out those sick patients who do not need to be tested for spreading the pathogen, especially in the event of an overwhelming increase in disease transmission. This work presents a screening support system that can precisely identify patients who do not carry the disease. The decision of the system is made on the basis of patient survey data that are easy to collect. A case study on a data set of symptomatic COVID-19 patients shows that the system can be effective in the initial phase of the epidemic. The case study presents an analysis of two classifiers that were tuned to achieve an assumed acceptable threshold of negative predictive values during classification. Additionally, an explanation of the obtained classification models is presented. The explanation enables the users to understand the basis of the decision made by the model. The obtained classification models provide the basis for the DECODE service, which could serve as support in screening patients with COVID-19 disease at the initial stage of the pandemic. Moreover, the data set constituting the basis for the analyses performed is made available to the research community. This data set, consisting of more than 3000 examples, is based on questionnaires collected at a hospital in Poland.

Background. The aim of a longitudinal, retrospective study was to establish variables predicting fracture incidence over a decade. Methods. The study sample comprises a group of 457 postmenopausal women aged over 55 years, recruited from the database of an outpatient osteoporotic clinic. Several variables with potential influence on bone status, including the measurement of body height and hip bone densitometry, were collected. BMD at the femoral neck (FN BMD) was established using a Prodigy device (Lunar, GE, USA). Current body height was compared with the maximal historical body height in early adulthood, as reported by the patient. Results. Three hundred and ninety-four women did not have fractures during the follow up, and 63 subjects presented fractures. Subjects with fracture had lower FN BMD with a T-score of −1.86 ± 1.04 compared to −1.44 ± 0.89 in those without fractures (p < 0.001). Mean height loss (HL) was 3.47 ± 2.11 cm in fractured subjects and 2.50 ± 2.47 cm in unfractured ones, and differed significantly, p < 0.01. Fracture incidence was significantly related to age, rheumatoid arthritis, falls, and previous fractures. In the multivariable analysis using logistic regression, FN BMD, baseline fracture, and HL were identified as the significant predictors of fractures of follow up. Conclusions. Osteoporotic fractures in postmenopausal women were predicted by FN BMD, prior fracture(s), and HL easily established during physical examination.