Alvah R. Cass, MD, SM

 

Angela Shepherd, MD
Angela J. Shepherd, MD

Osteoporosis

Health Promotion: Early Detection of Disease and Disease Prevention

Research projects focus on bone health: the early detection of osteoporosis and risk factors for fractures. Recent work focused on comparing clinical screening tools, the Osteoporosis Risk Assessment Instrument (ORAI) and Simple Calculated Osteoporosis Risk Estimate (SCORE), in a multiethnic patient population. Findings indicate that sensitivity for the two clinical screening tools is lower than previously reported and may limit their usefulness in a multiethnic patient population. On-going research focuses on the development and validation of a clinical prediction rule, the Male Osteoporosis Risk Estimation Score (MORES), to identify men at risk for osteoporosis and subsequent hip fracture who might benefit from dual-energy x-ray absorptiometry (DXA). In men aged 60 years and older, the MORES is a simple approach to identify men at risk for osteoporosis and refer them for confirmatory DXA scans. A recent grant application will investigate the fracture risk in adults with type 2 diabetes when selected medications are used in combination.

Publications:

Cass AR, Shepherd AJ, Asirot RL, Mahajan M, Nizami MQ. A comparison of the Male Osteoporosis Risk Estimation Score (MORES) and the FRAX™ in identifying men at risk for osteoporosis. Annals of Family Medicine. July/August 2016; 14(4): 365-369. doi:10.1370/afm.1947

Shepherd AJ, Howrey BT, Cass AR, Wilkinson GS. Osteoporosis therapy after fracture in elderly men. Journal of Clinical Outcomes Management. 2013; 53(7): 495-499.

Cass AR, Shepherd AJ. Validation of the male osteoporosis risk estimation score (MORES) in a primary care setting. Journal of the American Board of Family Medicine. 2013; 26(4): 436-444.

Shepherd AJ, Cass AR, Ray L, Tan A, Wilkinson GS. Treatment for older men with fractures.Osteoporosis International. 2012. 23(3): 1041-1051.

Baillargeon J, Kuo YF, Lin YL, Wilkinson GS, Goodwin JS. Osteonecrosis of the jaw in older osteoporosis patients treated with intravenous bisphosponates. The Annals of Pharmacotherapy. 2011. 45: 1199-1206.

Shepherd AJ, Cass AR, Ray L, Wilkinson GS. (May 5-8) “Post-Fracture Treatment for Osteoporosis in Elderly Males.” Paper presented at IOF World Congress on Osteoporosis. Florence, Italy.

 Shepherd AJ, Cass AR, Ray L. Determining risk of vertebral osteoporosis in men: validation of the male osteoporosis risk estimation score. J Am Board Fam Med. 2010; 23(2): 186-94.

Berenson AB, Rahman M, Wilkinson G. Racial differences in the correlates of bone mineral content/density and age at peak among reproductive-aged women. Osteoporos Int. 2009; 20:1439-49.

Wilkinson GS, Kuo YF, Freeman JL, Goodwin JS. Response: Re: Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw: a population-based analysis. J Natl Cancer Inst. 2008; 100:155-156.

Shepherd AJ, Cass AR, Carlson CA, Ray L. Development and internal validation of the male osteoporosis risk estimation score. Ann Fam Med. 2007; 5(6): 540-6.

Wilkinson GS, Kuo YF, Freeman JL, Goodwin JS. Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw: a population-based analysis. J Natl Cancer Inst. 2007;99:1016-24.

Cass AR, Shepherd AJ, Carlson CA. Osteoporosis risk assessment and ethnicity: validation and comparison of two clinical risk stratification instruments. J Gen Intern Med. 2006; 21(6): 630-5.

McNearney TA, Shepherd AJ, Chhabra A, Goel N. Primary Care House staff Attitudes Towards Osteoporosis Management. South Med J. 2006; 99(5):461-6.

Shepherd, AJ. An Overview of Osteoporosis. Altern Ther Health Med. 2004, 10(2):26-33.

Funding: 

All funding is listed as total costs (direct costs plus indirect costs)

Cass, AR: A comparative analysis of the FRAX® and the male osteoporosis risk estimation score. TAFP. 04/2012-03/2013. $5,000.

Cass, AR (PI), Shepherd, AJ: Clinical Validation of the MORES in a Primary Care Population. AHRQ R03. 9/08-09/11, $99,882.

Shepherd, AJ (PI), Wilkinson, G, Cass, AR: Has the rate of osteoporosis treatment in older men with fractures improved? The Joint AAFP/F-AAFP Grant Awards Program. 12/08-11/09, $29,579.

Shepherd, AJ (PI), Cass, AR: Validation of the Male Osteoporosis Risk Estimation (MORE) Index in the NHANES IV Dataset. The Joint AAFP/F-AAFP Grant Awards Program. 3/06-2/07, $23,685.

Cass, AR (PI), Shepherd, AJ: Clinical Stratification of Osteoporosis Risk in Women from an Ethnically Diverse Population. The Joint AAFP/F-AAFP Grant Awards Program. 9/02-02/04, $20,000.

UTMB ~ The University of Texas Medical Branch
Site Managed by the Department of Family Medicine

© 2016 The University of Texas Medical Branch. Please review our site policies and required links.The Department of Family Medicine, 301 University Boulevard, Galveston, Texas 77555-1123. Phone 409.772.0620. Fax 409.772.4296
Member, Texas Medical Center®