REMS for the prediction of incident fragility fractures
A 5-year follow-up study
Adami, Arioli, Bianchi, Brandi, Caffarelli, Cianferotti, Gatti, Girasole, Gonnelli, Manfredini, Muratore, E. Quarta & L. Quarta. Bone 134 (2020) 115297. doi.org/10.1016/j.bone.2020.115297
1,370
Women completed the 5-year study
Up to 5 yrs
Follow-up period tracking fractures
14.0%
Sustained a fragility fracture
OR 2.6
REMS fracture odds ratio vs DXA's 1.7
Why this study matters for your bone health
A bone density scan exists to answer one question: how likely is this person to break a bone? For decades, the standard tool for that question has been DEXA — and for decades, clinicians have known it is an imperfect predictor. Many people with dense bones still fracture, and many with thin bones never do.
This study set out to test whether REMS does the job better. It followed 1,516 women, of whom 1,370 completed follow-up of up to five years, and compared how well each technology's T-score identified the women who went on to sustain a fragility fracture.
The REMS T-score came out ahead. Over the follow-up period, it carried a higher odds ratio for fracture than the DXA T-score (2.6 versus 1.7 at the vertebral site) and a larger area under the ROC curve (0.66 versus 0.61) — meaning it separated the women who fractured from those who did not, more reliably.
What it means in practice: a REMS scan gives your physician a fracture-risk reading with better predictive accuracy than the T-score alone would provide — which is exactly the number that determines whether treatment is worth starting.
Importantly, REMS did not disagree with DXA. The two technologies correlated strongly overall (r = 0.92). REMS is not measuring something different — it is measuring the same bone with less interference, and extracting more predictive value from it.
What the study found
Four findings, in plain language.
- 1
REMS predicted fractures better than DXA
At the vertebral site, the odds ratio for an incident fragility fracture was 2.6 for REMS versus 1.7 for DXA. A higher odds ratio means the measurement was more strongly associated with whether a fracture actually occurred.
- 2
The difference held across the whole cohort
This was a multicenter, prospective study — patients were enrolled, then followed forward in time to see who fractured. That design is what makes a prediction claim meaningful, because the outcome was unknown when the scan was taken.
- 3
REMS and DXA broadly agreed
The two methods correlated strongly overall (r = 0.92), so REMS is not an outlier measurement that contradicts DXA. It is a different, radiation-free way of arriving at a comparable density reading.
- 4
A meaningful share of the cohort fractured
About 14.0% of the women who completed follow-up sustained a fragility fracture. The study had enough fracture events to test how well each technology identified them — which is what separates this from a study that can only report correlation.
Study details
- Full title
- Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up study
- Authors
- Giovanni Adami, Giovanni Arioli, Gerolamo Bianchi, Maria Luisa Brandi, Carla Caffarelli, Luisella Cianferotti, Davide Gatti, Giuseppe Girasole, Stefano Gonnelli, Monica Manfredini, Maurizio Muratore, Eugenio Quarta, Laura Quarta
- Journal
- Bone, volume 134 (2020), article 115297
- Published
- 21 February 2020
- DOI
- 10.1016/j.bone.2020.115297
- Population
- 1,516 women enrolled; 1,370 completed follow-up of up to 5 years
- Comparison
- REMS T-score versus DXA T-score for predicting incident fragility fracture
- Key result
- Odds ratio 2.6 (REMS) versus 1.7 (DXA) at the vertebral site; AUC 0.66 versus 0.61
Get the measurement this study is about
A REMS bone density scan takes about 15 minutes, uses no radiation, and reports a fracture-risk reading grounded in peer-reviewed evidence. Serving patients across New York and New Jersey.
- No radiation at any point during the scan
- Results not distorted by arthritis or calcium buildup
- Safe to repeat for monitoring as often as your physician recommends
More published research on REMS technology is collected on the research library page.