Manitoba Health

Bone Density Testing Information for Researchers

Research – Past, Present and Future

The Manitoba Bone Density Program Committee is responsible for overseeing the delivery of clinical services to the population of Manitoba.  At the same time, the Program's mandate includes a commitment to clinical researchers

"... to ensure that the operation of bone density units contributes to research and other academic activities that benefit the residents of Manitoba".

Bone densitometry is an important outcomes measure in osteoporosis research, and researchers should have access to this technology.  Furthermore, Manitoba has the largest population-based database of clinical DXA results in the world.  This is a valuable research resource, and would like to encourage other researchers to take advantage of it.  After removing names and other personal identifiers (in accordance with the Personal Health Information Act), the anonymous database can be linked with administrative health files.  This creates unique research opportunities which are not available anywhere else.  The most recent version of the database covers the period January 1, 1990-March 31, 2006 and contains more than 57,000 scan results.

Approval Procedure

The Manitoba Bone Density Program Committee must review each application to use the provincially operated bone densitometers or data for clinical research.  Inquiries should be addressed to Dr. William D. Leslie (bleslie@sbgh.mb.ca), Chair of the Manitoba Bone Density Program Committee.

The researcher must provide written approval from the relevant Faculty of Medicine Research Ethics Board (REB) and institutional Research Review Committee (RRC).  If the project also involves linkage with provincial health services data from Manitoba Health then it also requires approval from the Health Information and Privacy Committee (HIPC) and review by the Manitoba Centre for Health Policy (MCHP).  The Manitoba Bone Density Program should be acknowledged in any publication or presentation that arises from using its resources.

Any costs related to hardware, software, quality assurance, data manipulation or non-clinical testing services will need to be covered by the researcher. 

The Principal Investigator will be asked to attend a meeting to present the protocol and address the following questions:

1. What is the clinical value of this project?
   
   
2. What is the status of any required approvals and/or funding requests?
   
   
3. Does the research require access to the Manitoba Bone Density Program's database?
   
   
4. Does the research require access to administrative health from Manitoba Health?
   
   If yes:
   - Include a copy of the HIPC application form.
   
   
5. Does the research require additional non-clinical DXA testing?
   
   If yes:
   - Is this project better suited to a provincial bone densitometer or a private bone densitometer?
   - Are any additional hardware, software or quality assurance procedures required for the project?
   - How will patients be scheduled to minimize impact on clinical services?
   - How will the Manitoba Program be reimbursed for costs?
   - What is the expected number of patients, number of tests, testing schedule and recruitment period?

Publications from the Manitoba Bone Density Program

Prevalent vertebral fracture on bone density lateral spine (VFA) images in routine clinical practice predict incident fractures.
Schousboe JT, Lix LM, Morin SN, Derkatch S, Bryanton M, Alhrbi M, Leslie WD.
Bone. 2019 Apr;121:72-79.  [Pubmed link]

Administrative healthcare data applied to fracture risk assessment.
Yang S, Leslie WD, Morin SN, Lix LM.
Osteoporos Int. 2019 Mar;30(3):565-571.  [Pubmed link]

Factors associated with receiving bone mineral density screening among people with multiple sclerosis.
Bisson EJ, Ekuma O, Marrie RA, Leslie WD, Finlayson ML.
Mult Scler Relat Disord. 2019 Feb;28:305-308.  [Pubmed link]

Fracture Risk Indices From DXA-Based Finite Element Analysis Predict Incident Fractures Independently From FRAX: The Manitoba BMD Registry.
Leslie WD, Luo Y, Yang S, Goertzen AL, Ahmed S, Delubac I, Lix LM.
J Clin Densitom. 2019 Feb 8.  [Epub ahead of print]  [Pubmed link]

The Fracture Risk Assessment Tool (FRAX®) predicts fracture risk in patients with chronic kidney disease.
Whitlock RH, Leslie WD, Shaw J, Rigatto C, Thorlacius L, Komenda P, Collister D, Kanis JA, Tangri N.
Kidney Int. 2019 Feb;95(2):447-454.  [Pubmed link]

Accuracy of FRAX® in People With Multiple Sclerosis.
Bisson EJ, Finlayson ML, Ekuma O, Marrie RA, Leslie WD.
J Bone Miner Res. 2019 Jan 28  [Epub ahead of print]  [Pubmed link]

Comparison of Methods for Improving Fracture Risk Assessment in Diabetes: The Manitoba BMD Registry.
Leslie WD, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D.
J Bone Miner Res. 2018 Nov;33(11):1923-1930.  [Pubmed link]

Long-term effects of inhaled corticosteroids on bone mineral density in older women with asthma or COPD: a registry-based cohort study.
Chen W, Johnson KM, FitzGerald JM, Sadatsafavi M, Leslie WD.
Arch Osteoporos. 2018 Oct 29;13(1):116.  [Pubmed link]

The diagnostic threshold for osteoporosis impedes fracture prevention in women at high risk for fracture: A registry-based cohort study.
Leslie WD, Seeman E, Morin SN, Lix LM, Majumdar SR.
Bone. 2018 Sep;114:298-303.  [Pubmed link]

In which patients does lumbar spine trabecular bone score (TBS) have the largest effect?
Martineau P, Leslie WD, Johansson H, Harvey NC, McCloskey EV, Hans D, Kanis JA.
Bone. 2018 Aug;113:161-168.  [Pubmed link]

Comparison of femoral strength and fracture risk index derived from DXA-based finite element analysis for stratifying hip fracture risk: A cross-sectional study.
Yang S, Luo Y, Yang L, Dall'Ara E, Eastell R, Goertzen AL, McCloskey EV, Leslie WD, Lix LM.
Bone. 2018 May;110:386-391.  [Pubmed link]

Automation of a DXA-based finite element tool for clinical assessment of hip fracture risk.
Luo Y, Ahmed S, Leslie WD.
Comput Methods Programs Biomed. 2018 Mar;155:75-83.  [Pubmed link]

Performance of FRAX in clinical practice according to sex and osteoporosis definitions: the Manitoba BMD registry.
Leslie WD, Majumdar SR, Morin SN, Lix LM, Schousboe JT, Ensrud KE, Johansson H, McCloskey EV, Kanis JA.
Osteoporos Int. 2018 Mar;29(3):759-767.  [Pubmed link]

Risk-equivalent T-score adjustment for using lumbar spine trabecular bone score (TBS): the Manitoba BMD registry.
Leslie WD, Shevroja E, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D.
Osteoporos Int. 2018 Mar;29(3):751-758.  [Pubmed link]

Measuring improvement in fracture risk prediction for a new risk factor: a simulation.
Lix LM, Leslie WD, Majumdar SR.
BMC Res Notes. 2018 Jan 22;11(1):62.  [Pubmed link]

Automated DXA-based finite element analysis for hip fracture risk stratification: a cross-sectional study.
Yang S, Leslie WD, Luo Y, Goertzen AL, Ahmed S, Ward LM, Delubac I, Lix LM.
Osteoporos Int. 2018 Jan;29(1):191-200.   [Pubmed link]

Effects of obesity and diabetes on rate of bone density loss.
Leslie WD, Morin SN, Majumdar SR, Lix LM.
Osteoporos Int. 2018 Jan;29(1):61-67.  [Pubmed link]

International Classification of Diseases (ICD)-coded obesity predicts risk of incident osteoporotic fracture.
Yang S, Lix LM, Yan L, Hinds AM, Leslie WD.
PLoS One. 2017 Dec 7;12(12):e0189168.  [Pubmed link]

Total Hip Bone Area Affects Fracture Prediction With FRAX® in Canadian White Women.
Leslie WD, Lix LM, Majumdar SR, Morin SN, Johansson H, Odén A, McCloskey EV, Kanis JA.
J Clin Endocrinol Metab. 2017 Nov 1;102(11):4242-4249.  [Pubmed link]

Clinical performance of an updated trabecular bone score (TBS) algorithm in men and women: the Manitoba BMD cohort.
Schacter GI, Leslie WD, Majumdar SR, Morin SN, Lix LM, Hans D.
Osteoporos Int. 2017 Nov;28(11):3199-3203.  [Pubmed link]

FRAX for fracture prediction shorter and longer than 10 years: the Manitoba BMD registry.
Leslie WD, Majumdar SR, Morin SN, Lix LM, Johansson H, Oden A, McCloskey EV, Kanis JA.
Osteoporos Int. 2017 Sep;28(9):2557-2564.  [Pubmed link]

Clinical Utility of Using Lumbar Spine Trabecular Bone Score to Adjust Fracture Probability: The Manitoba BMD Cohort.
Martineau P, Leslie WD, Johansson H, Oden A, McCloskey EV, Hans D, Kanis JA.
J Bone Miner Res. 2017 Jul;32(7):1568-1574.  [Pubmed link]

Association of Mental Disorders and Related Medication Use With Risk for Major Osteoporotic Fractures.
Bolton JM, Morin SN, Majumdar SR, Sareen J, Lix LM, Johansson H, Odén A, McCloskey EV, Kanis JA, Leslie WD.
JAMA Psychiatry. 2017 Jun 1;74(6):641-648. [Pubmed link]

Accuracy of Offspring-Reported Parental Hip Fractures: A Novel Population-Based Parent-Offspring Record Linkage Study.
Lix LM, Leslie WD, Yang S, Yan L, Walld R, Morin SN, Majumdar SR, Roos LL.
Am J Epidemiol. 2017 May 15;185(10):974-981.  [Pubmed link]

Objectively-Verified Parental Non-Hip Major Osteoporotic Fractures and Offspring Osteoporotic Fracture Risk: A Population-Based Familial Linkage Study.
Yang S, Leslie WD, Walld R, Roos LL, Morin SN, Majumdar SR, Lix LM.
J Bone Miner Res. 2017 Apr;32(4):716-721.  [Pubmed link]

Change in Trabecular Bone Score (TBS) With Antiresorptive Therapy Does Not Predict Fracture in Women: The Manitoba BMD Cohort.
Leslie WD, Majumdar SR, Morin SN, Hans D, Lix LM.
J Bone Miner Res. 2017 Mar;32(3):618-623.  [Pubmed link]

Longer Duration of Diabetes Strongly Impacts Fracture Risk Assessment: The Manitoba BMD Cohort.
Majumdar SR, Leslie WD, Lix LM, Morin SN, Johansson H, Oden A, McCloskey EV, Kanis JA.
J Clin Endocrinol Metab. 2016 Nov;101(11):4489-4496.  [Pubmed link]

Change in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture Effect in Routine Clinical Practice: A Registry-Based Cohort Study.
Leslie WD, Majumdar SR, Morin SN, Lix LM.
Ann Intern Med. 2016 Oct 4;165(7):465-472. [Pubmed link]

Direct comparison of FRAX(R) and a simplified fracture risk assessment tool in routine clinical practice: a registry-based cohort study.
Leslie WD, Majumdar SR, Lix LM, Josse RG, Johansson H, Oden A, McCloskey EV, Kanis JA.
Osteoporos Int. 2016 Sep;27(9):2689-2695.  [Pubmed link]

Antiresorptive therapy and newly diagnosed diabetes in women: a historical cohort study.
Yang S, Leslie WD, Morin SN, Majumdar SR, Lix LM.
Diabetes Obes Metab. 2016 Sep;18(9):875-81.  [Pubmed link]

Objectively Verified Parental Hip Fracture Is an Independent Risk Factor for Fracture: a Linkage Analysis of 478,792 Parents and 261,705 Offspring.
Yang S, Leslie WD, Yan L, Walld R, Roos LL, Morin SN, Majumdar SR, Lix LM.
J Bone Miner Res. 2016 Sep;31(9):1753-9.  [Pubmed link]

Adjusting Hip Fracture Probability in Men and Women Using Hip Axis Length: the Manitoba Bone Density Database.
Leslie WD, Lix LM, Morin SN, Johansson H, Odén A, McCloskey EV, Kanis JA.
J Clin Densitom. 2016 Jul-Sep;19(3):326-31 [Pubmed link]

Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study.
Padwal R, Leslie WD, Lix LM, Majumdar SR.
Ann Intern Med. 2016 Apr 19;164(8):532-41. [Pubmed link]

Trabecular bone score in kidney transplant recipients.
Naylor KL, Lix LM, Hans D, Garg AX, Rush DN, Hodsman AB, Leslie WD.
Osteoporos Int. 2016 Mar;27(3):1115-1121 [Pubmed link]

Associations of Body Mass Index With Incident Fractures and Hip Structural Parameters in a Large Canadian Cohort.
Shen J, Leslie WD, Nielson CM, Majumdar SR, Morin SN, Orwoll ES.
J Clin Endocrinol Metab. 2016 Feb;101(2):476-84.  [Pubmed link]

Towards better use of the net reclassification improvement (NRI) index.
Leslie WD, Schousboe JT, Lix LM.
Osteoporos Int. 2016 Jan;27(1):411-2.  [Pubmed link]

Fracture prediction from repeat BMD measurements in clinical practice.
Leslie WD, Brennan-Olsen SL, Morin SN, Lix LM.
Osteoporos Int. 2016 Jan;27(1):203-10 [Pubmed link]

Spine-Hip Thickness Difference Measured by Dual-Energy X-ray Absorptiometry Is Associated With Diabetes Mellitus in Women and Men.
Schacter GI, Leslie WD.
J Clin Densitom. 2015 Oct;18(4):512-8. [Pubmed link]

Cost-effectiveness of fracture prevention in rural women with limited access to dual-energy X-ray absorptiometry.
Ito K, Leslie WD.
Osteoporos Int. 2015 Aug;26(8):2111-9. [Pubmed link]

Adjusting fracture probability by trabecular bone score.
McCloskey EV, Odén A, Harvey NC, Leslie WD, Hans D, Johansson H, Kanis JA.
Calcif Tissue Int. 2015 Jun;96(6):500-9. [Pubmed link]

Hip axis length is a FRAX- and bone density-independent risk factor for hip fracture in women.
Leslie WD, Lix LM, Morin SN, Johansson H, Odén A, McCloskey EV, Kanis JA.
J Clin Endocrinol Metab. 2015 May;100(5):2063-70. [Pubmed link]

Why does rate of bone density loss not predict fracture risk?
Leslie WD, Majumdar SR, Morin SN, Lix LM.
J Clin Endocrinol Metab. 2015 Feb;100(2):679-83. [Pubmed link]

Does diabetes modify the effect of FRAX risk factors for predicting major osteoporotic and hip fracture?
Leslie WD, Morin SN, Lix LM, Majumdar SR.
Osteoporos Int. 2014 Dec;25(12):2817-24. [Pubmed link]

Long-term changes in bone mineral density in kidney transplant recipients.
Naylor KL, Garg AX, Hodsman AB, Rush DN, Leslie WD.
Transplantation. 2014 Dec 27;98(12):1279-85. [Pubmed link]

Spine bone texture assessed by trabecular bone score (TBS) predicts osteoporotic fractures in men: the Manitoba Bone Density Program.
Leslie WD, Aubry-Rozier B, Lix LM, Morin SN, Majumdar SR, Hans D.
Bone. 2014 Oct;67:10-4. [Pubmed link]

Lumbar spine texture enhances 10-year fracture probability assessment.
Leslie WD, Johansson H, Kanis JA, Lamy O, Oden A, McCloskey EV, Hans D.
Osteoporos Int. 2014 Sep;25(9):2271-7. [Pubmed link]

Estimated lean mass and fat mass differentially affect femoral bone density and strength index but are not FRAX independent risk factors for fracture.
Leslie WD, Orwoll ES, Nielson CM, Morin SN, Majumdar SR, Johansson H, Odén A, McCloskey EV, Kanis JA.
J Bone Miner Res. 2014 Nov;29(11):2511-9. [Pubmed link]

The importance of previous fracture site on osteoporosis diagnosis and incident fractures in women.
Morin SN, Lix LM, Leslie WD.
J Bone Miner Res. 2014 Jul;29(7):1675-80. PMID: 24535832   [Pubmed link]

FRAX predicts fracture risk in kidney transplant recipients.
Naylor KL, Leslie WD, Hodsman AB, Rush DN, Garg AX.
Transplantation. 2014 May 15;97(9):940-5.  [Pubmed link]     

Can change in FRAX score be used to "treat-to-target"? A population-based cohort study.
Leslie WD, Majumdar SR, Lix LM, Morin SN, Johansson H, Oden A, McCloskey E, Kanis JA.
Journal of Bone and Mineral Research, 2014 May;29(5):1074-80. [Pubmed link]     

Major Osteoporotic to Hip Fracture Ratios in Canadian Men and Women with Swedish Comparisons:  A Population Based Analysis.
Lam A, Leslie WD, Lix LM, Yogendran M, Morin SN, Majumdar SR.
J Bone Miner Res. 2014 May;29(5):1067-73 [Pubmed link]     

Temporal trends in obesity, osteoporosis treatment, bone mineral density and fracture rates:  A population-based historical cohort study.
Leslie WD, Lix LM, Yogendran MS, Morin SN, Metge CJ, Majumdar SR.
J Bone Miner Res. 2014 Apr;29(4):952-9 [Pubmed link]                                

Definition of Osteoporosis by Bone Density Criteria in Men: Effect of Using Female Instead of Male Young Reference Data Depends on Skeletal Site and Densitometer Manufacturer.
Schousboe JT, Tanner SB, Leslie WD.
J Clin Densitom. 2014 Apr-Jun;17(2):301. [Pubmed link]

Ancestral differences in femoral neck axis length: Possible implications for forensic anthropological analyses.
Christensen AM, Leslie WD, Baim S.
Forensic Sci Int. 2014 Mar;236:193. [Pubmed link]

Estimation of Trochanteric Soft Tissue Thickness From Dual-Energy X-ray Absorptiometry.
Schacter I, Leslie WD.
J Clin Densitom. 2014 Jan-Mar;17(1):54-9. [Pubmed link]

A meta-analysis of the association of fracture risk and body mass index in women.
Johansson H, Kanis JA, Odén A, McCloskey E, Chapurlat RD, Christiansen C, Cummings SR, Diez-Perez A, Eisman JA, Fujiwara S, Glüer CC, Goltzman D, Hans D, Khaw KT, Krieg MA, Kröger H, LaCroix AZ, Lau E, Leslie WD, Mellström D, Melton LJ 3rd, O'Neill TW, Pasco JA, Prior JC, Reid DM, Rivadeneira F, van Staa T, Yoshimura N, Zillikens MC.
J Bone Miner Res. 2014 Jan;29(1):223-33. [Pubmed link]     

Is lower income associated with an increased likelihood of qualification for treatment for osteoporosis in Canadian women?
Brennan SL, Leslie WD, Lix LM.
Osteoporos Int. 2014 Jan;25(1):273-9. [Pubmed link]

FRAX provides robust fracture prediction regardless of socioeconomic status.
Brennan SL, Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA.
Osteoporos Int. 2014 Jan;25(1):61-9. [Pubmed link]

Direct comparison of eight national FRAX® tools for fracture prediction and treatment qualification in Canadian women.
Leslie WD, Majumdar SR.
Arch Osteoporos. 2013 Dec;8(1-2):145.  [Pubmed link]

Of fracture thresholds and bone mineral density reference data:  does one size really fit all?
Majumdar SR, Leslie WD.
J Clin Densitom. 2013 Oct-Dec;16(4):543-8. [Pubmed link]

Selection of women aged 50-64 yr for bone density measurement.
Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA, Manitoba Bone Density Program.
J Clin Densitom. 2013 Oct-Dec;16(4):570-8. [Pubmed link]

Treatment implications for men when switching from male to female bone mineral density reference data:  the Manitoba Bone Density Program.
Leslie WD, Majumdar SR.
J Clin Densitom. 2013 Oct-Dec;16(4):537-42. [Pubmed link]     

Associations between adverse social position and bone mineral density in women aged 50 years or older: data from the Manitoba Bone Density Program.
Brennan SL, Leslie WD, Lix LM.
Osteoporos Int. 2013 Sep;24(9):2405-12. [Pubmed link]  

Clinical factors associated with trabecular bone score.
Leslie WD, Krieg MA, Hans D, Manitoba Bone Density Program.
J Clin Densitom. 2013 Jul-Sep;16(3):374-9. [Pubmed link]

Precision study of DXA-based patient-specific finite element modeling for assessing hip fracture risk.
Luo Y, Ferdous Z, Leslie WD.
Int j numer method biomed eng. 2013 May;29(5):615-29.  [Pubmed link]                        

Cost-effectiveness of two inexpensive postfracture osteoporosis interventions: results of a randomized trial.
Majumdar SR, Lier DA, Leslie WD.
J Clin Endocrinol Metab. 2013 May;98(5):1991-2000. [Pubmed link]                          

Inflammatory bowel disease and the risk of fracture after controlling for FRAX.
Targownik LE, Bernstein CN, Nugent Z, Johansson H, Oden A, McCloskey E, Kanis JA, Leslie WD.
J Bone Miner Res. 2013 May;28(5):1007-13.  [Pubmed link]

Inflammatory bowel disease has a small effect on bone mineral density and risk for osteoporosis.
Targownik LE, Bernstein CN, Nugent Z, Leslie WD.
Clin Gastroenterol Hepatol. 2013 Mar;11(3):278-85. [Pubmed link]

Effects of anti-resorptive agents on Trabecular Bone Score (TBS) in older women.
Krieg M-A, Aubry-Rozier B, Hans D, Leslie WD.
Osteoporos Int. 2013 Mar;24(3):1073-8. [Pubmed link]

TBS (Trabecular Bone Score) and diabetes-related fracture risk.
Leslie WD, Aubry-Rozier B, Lamy O, Hans D.
J Clin Endocrinol Metab. 2013 Feb;98(2):602-9.  [Pubmed link]

Competing mortality and fracture risk assessment.
Leslie WD, Lix L, Wu X.
Osteoporos Int. 2013 Feb;24(2):681-8. [Pubmed link]

Longitudinal change in BMD in a population based cohort of patients with inflammatory bowel disease.
Targownik LE, Leslie WD, Carr R, Clara I, Miller N, Rogala R, Graff LA, Walker JR, Bernstein CN.
Calcif Tissue Int. 2012 Nov;91(5):356-63. [Pubmed link]

Does osteoporosis therapy invalidate FRAX for fracture prediction?
Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA.
J Bone Miner Res. 2012 Jun;27(6):1243-51. [Pubmed link]

Osteoporosis-related fracture case definitions for population-based administrative data.
Lix LM, Azimaee M, Acan B, Caetano P, Morin S, Metge C, Goltzman D, Kreiger N, Prior J, Leslie WD.
BMC Public Health. 2012 May 18;12:301. [Pubmed link]

A population-based analysis of the post-fracture care gap 1996-2008: the situation is not improving.
Leslie WD, Giangregorio LM, Yogendran M, Azimaee M, Morin S, Metge C, Caetano P, Lix LM.
Osteoporos Int. 2012 May;23(5):1623-9. [Pubmed link]

Population-based trends in osteoporosis management after new initiations of long-term systemic glucocorticoids (1998-2008).
Majumdar SR, Lix LM, Yogendran M, Morin SN, Metge CJ, Leslie WD.
J Clin Endocrinol Metab. 2012 Apr;97(4):1236-42. [Pubmed link]

Heart failure is a clinically and densitometrically independent risk factor for osteoporotic fractures: Population-based cohort study of 45,509 subjects.
Majumdar SR, Ezekowitz JA, Lix LM, Leslie WD.
J Clin Endocrinol Metab. 2012 Apr;97(4):1179-86. [Pubmed link]

Rate of bone density change does not enhance fracture prediction in routine clinical practice.
Leslie WD, Morin SN, Lix LM.
J Clin Endocrinol Metab. 2012 Apr;97(4):1211-8. [Pubmed link]

Assessment of fracture risk.
Baim S, Leslie WD.
Curr Osteoporos Rep. 2012 Mar;10(1):28-41. [Pubmed link]

The post-fracture care gap among Canadian First Nations peoples: A retrospective cohort study.
Leslie WD, Brennan S, Prior HJ, Lix LM, Metge CJ, Elias B.
Osteoporos Int. 2012 Mar;23(3):929-36. [Pubmed link]

Ankle fractures do not predict osteoporotic fractures in women with or without diabetes.
Pritchard JM, Giangregorio LM, Ioannidis G, Papaioannou A, Adachi JD, Leslie WD.
Osteoporos Int. 2012 Mar;23(3):957-62. [Pubmed link]

A comparative study of using non hip bone density inputs with FRAX®.
Leslie WD,  Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA.
Osteoporos Int. 2012 Mar;23(3):853-60.  [Pubmed link]

Closing the gap in postfracture care at the population level: a randomized controlled trial.
Leslie WD, LaBine L, Klassen P, Dreilich D, Caetano PA.
CMAJ. 2012 Feb 21;184(3):290-6.  [Pubmed link]

FRAX underestimates fracture risk in patients with diabetes.
Giangregorio LM, Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA. 
J Bone Miner Res. 2012 Feb;27(2):301-8. [Pubmed link]

Bone-density testing interval and transition to osteoporosis in older women [letter to the editor].
Leslie WD, Morin S, Lix LM.
N Engl J Med. 2012 Jan 19;366(3):225-33. [Pubmed link]

Fracture risk assessment without bone density measurement in routine clinical practice.
Leslie WD, Morin S, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA; for the Manitoba Bone Density Program.
Osteoporos Int. 2012 Jan;23(1):75-85. [Pubmed link]

FRAX® with and without BMD.
Kanis JA, McCloskey E, Johansson H, Oden A, Leslie WD.
Calcif Tissue Int. 2012 Jan;90(1):1-13. [Pubmed link]

High fracture probability with FRAX(®) usually indicates densitometric osteoporosis: implications for clinical practice.
Leslie WD, Majumdar SR, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA; for the Manitoba Bone Density Program.
Osteoporos Int. 2012 Jan;23(1):391-7. [Pubmed link]

A preliminary DXA-based finite element model for assessing osteoporotic hip fracture risk.
Luo Y, Ferdous Z, Leslie WD.
Proc Inst Mech Eng H. 2011 Dec;225(12):1188-95. [Pubmed link]

Bone micro-architecture assessed by TBS predicts osteoporotic fractures independent of bone density: The Manitoba study.
Hans D, Goertzen AL, Krieg MA, Leslie WD.
J Bone Miner Res. 2011 Nov;26(11):2762-9. [Pubmed link]

Clinical Risk Factors for Fracture in Diabetes: A Matched Cohort Analysis.
Fraser LA, Pritchard J, Ioannidis G, Giangegorio LM, Adachi JD, Papaioannou A, Leslie WD.
J Clin Densitom. 2011 Oct-Dec;14(4):416-21.[Pubmed link]

Longitudinal Evaluation of Bone Mineral Density and Body Composition in Patients With Positive Celiac Serology.
Duerksen DR, Leslie WD.
J Clin Densitom. 2011 Oct-Dec;14(4):478-83. [Pubmed link]

Closing the Postfracture Care Gap Using Administrative Health Databases: Design and Implementation of a Randomized Controlled Trial.
Caetano PA, Labine L, Klassen P, Dreilich D, Leslie WD.
J Clin Densitom. 2011 Oct-Dec;14(4):422-7. [Pubmed link]

Effects of FRAX(®) Model Calibration on Intervention Rates: A Simulation Study.
Leslie WD, Lix LM; Manitoba Bone Density Program.
J Clin Densitom. 2011 Jul-Sep;14(3):272-8. [Pubmed link]

Spine-Hip T-Score Difference Predicts Major Osteoporotic Fracture Risk Independent of FRAX(®): A Population-Based Report From CAMOS.
Leslie WD, Kovacs CS, Olszynski WP, Towheed T, Kaiser SM, Prior JC, Josse RG, Jamal SA, Kreiger N, Goltzman D; CaMos Research Group.
J Clin Densitom. 2011 Jul-Sep;14(3):286-93. [Pubmed link]

Fracture Burden in Relation to Low Bone Mineral Density and FRAX(®) Probability.
Leslie WD, Morin S.
J Clin Densitom. 2011 Jul-Sep;14(3):279-85. [Pubmed link]

Risk of low bone mineral density associated with psychotropic medications and mental disorders in postmenopausal women.
Bolton JM, Targownik LE, Leung S, Sareen J, Leslie WD.
J Clin Psychopharmacol. 2011 Feb;31(1):56-60. [Pubmed link]

Construction of a FRAX(®) model for the assessment of fracture probability in Canada and implications for treatment.
Leslie WD, Lix LM, Langsetmo L, Berger C, Goltzman D, Hanley DA, Adachi JD, Johansson H, Oden A, McCloskey E, Kanis JA.
Osteoporos Int. 2011 Mar;22(3):817-27. [Pubmed link]

Construction and validation of a simplified fracture risk assessment tool for Canadian women and men: results from the CaMos and Manitoba cohorts.
Leslie WD, Berger C, Langsetmo L, Lix LM, Adachi JD, Hanley DA, Ioannidis G, Josse RG, Kovacs CS, Towheed T, Kaiser S, Olszynski WP, Prior JC, Jamal S, Kreiger N, Goltzman D; Canadian Multicentre Osteoporosis Study (CaMos) Research Group.
Osteoporos Int. 2011 Jun;22(6):1873-83. [Pubmed link]

Bone mineral density and risk of postmenopausal breast cancer.
Grenier D, Cooke AL, Lix L, Metge C, Lu H, Leslie WD.
Breast Cancer Res Treat. 2011 Apr;126(3):679-86. [Pubmed link]

Spine-hip discordance and fracture risk assessment: a physician-friendly FRAX enhancement.
Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA.
Osteoporos Int. 2011 Mar;22(3):839-47. [Pubmed link]

Absolute fracture risk assessment using lumbar spine and femoral neck bone density measurements: Derivation and validation of a hybrid system.
Leslie WD, Lix LM; for the Manitoba Bone Density Program.
J Bone Miner Res. 2011 Mar;26(3):460-7. [Pubmed link]

Validation of a case definition for osteoporosis disease surveillance.
Leslie WD, Lix LM, Yogendran MS.
Osteoporos Int. 2011 Jan;22(1):37-46. [Pubmed link]

A before-and-after study of fracture risk reporting and osteoporosis treatment initiation.
Leslie WD, Morin S, Lix LM.
Ann Intern Med. 2010 Nov 2;153(9):580-6. [Pubmed link]

Independent clinical validation of a Canadian FRAX tool: fracture prediction and model calibration.
Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA; Manitoba Bone Density Program.
J Bone Miner Res. 2010 Nov;25(11):2350-8. [Pubmed link]

Abdominal fat from spine dual-energy x-ray absorptiometry and risk for subsequent diabetes.
Leslie WD, Ludwig SM, Morin S.
J Clin Endocrinol Metab. 2010 Jul;95(7):3272-6. [Pubmed link]

Time since prior fracture is a risk modifier for 10-year osteoporotic fractures.
Giangregorio LM, Leslie WD; Manitoba Bone Density Program.
J Bone Miner Res. 2010 Jun;25(6):1400-5. [Pubmed link]

Simplified 10-year absolute fracture risk assessment: a comparison of men and women.
Leslie WD, Lix LM; Manitoba Bone Density Program.
J Clin Densitom. 2010 Apr-Jun;13(2):141-6. [Pubmed link]

Proton pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss.
Targownik LE, Lix LM, Leung S, Leslie WD.
Gastroenterology. 2010 Mar;138(3):896-904. [Pubmed link]

Positive celiac disease serology and reduced bone mineral density in adult women.
Duerksen DR, Leslie WD.
Can J Gastroenterol. 2010 Feb;24(2):103-7. [Pubmed link]

Imputation of ten year osteoporotic fracture rates from hip fractures: A clinical validation study.
Leslie WD, Lix LM; for the Manitoba Bone Density Program.
J Bone Miner Res. 2010 Feb;25(2):388-92. [Pubmed link]

Prediction of body composition from spine and hip bone densitometry.
Leslie WD.
J Clin Densitom. 2009 Oct-Dec;12(4):428-33. [Pubmed link]

Prediction of hip and other osteoporotic fractures from hip geometry in a large clinical cohort.
Leslie WD, Pahlavan PS, Tsang JF, Lix LM; Manitoba Bone Density Program.
Osteoporos Int. 2009 Oct;20(10):1767-74. [Pubmed link]

Factors predicting osteoporosis treatment initiation in a regionally based cohort.
Cranney A, Tsang JF, Leslie WD.
Osteoporos Int. 2009 Sep;20(9):1621-5. [Pubmed link]

High bone mineral density is associated with high body mass index.
Morin S, Leslie WD; Manitoba Bone Density Program.
Osteoporos Int. 2009 Jul;20(7):1267-71. [Pubmed link]

Simplified system for absolute fracture risk assessment: clinical validation in Canadian women.
Leslie WD, Tsang JF, Lix LM; Manitoba Bone Density Program.
J Bone Miner Res. 2009 Feb;24(2):353-60. [Pubmed link]

Using multiple data features improved the validity of osteoporosis case ascertainment from administrative databases.
Lix LM, Yogendran MS, Leslie WD, Shaw SY, Baumgartner R, Bowman C, Metge C, Gumel A, Hux J, James RC.
J Clin Epidemiol. 2008 Dec;61(12):1250-60. [Pubmed link]

10-year probability of recurrent fractures following wrist and other osteoporotic fractures in a large clinical cohort: an analysis from the Manitoba Bone Density Program.
Hodsman AB, Leslie WD, Tsang JF, Gamble GD.
Arch Intern Med. 2008 Nov 10;168(20):2261-7. [Pubmed link]

Heteroscedastic regression analysis of factors affecting BMD monitoring.
Sadatsafavi M, Moayyeri A, Wang L, Leslie WD; Manitoba Bone Density Program.
J Bone Miner Res. 2008 Nov;23(11):1842-9. [Pubmed link]

Optimal decision criterion for detecting change in bone mineral density during serial monitoring: a Bayesian approach.
Sadatsafavi M, Moayyeri A, Wang L, Leslie WD.
Osteoporos Int. 2008 Nov;19(11):1589-96. [Pubmed link]

Validation of ten-year fracture risk prediction: a clinical cohort study from the Manitoba Bone Density Program.
Leslie WD, Tsang JF, Lix LM.
Bone. 2008 Oct;43(4):667-71. [Pubmed link]

Postfracture care for older women: gaps between optimal care and actual care.
Metge CJ, Leslie WD, Manness LJ, Yogendran M, Yuen CK, Kvern B; Maximizing Osteoporosis Management in Manitoba Steering Committee.
Can Fam Physician. 2008 Sep;54(9):1270-6. [Pubmed link]

Effect of total hip bone area on osteoporosis diagnosis and fractures.
Leslie WD, Tsang JF, Lix LM.
J Bone Miner Res. 2008 Sep;23(9):1468-76. [Pubmed link]

Weight and body mass index predict bone mineral density and fractures in women aged 40 to 59 years.
Morin S, Tsang JF, Leslie WD.
Osteoporos Int. 2008 Jul 17. 2009 Mar;20(3):363-70. [Pubmed link]

Absolute fracture risk reporting in clinical practice: a physician-centered survey.
Leslie WD; Manitoba Bone Density Program Committee.
Osteoporos Int. 2008 Apr;19(4):459-63. [Pubmed link]

Factors affecting short-term bone density precision assessment and the effect on patient monitoring.
Leslie WD.
J Bone Miner Res. 2008 Feb;23(2):199-204. [Pubmed link]

Sample size requirements for bone density precision assessments and effect on patient categorization: A Monte Carlo simulation study.
Moayyeri A, Sadatsafavi M, Leslie WD; for the Manitoba Bone Density Program.
Bone. 2007 Oct;41(4):679-84. [PubMed link]

A new approach for quantifying change and test precision in bone densitometry.
Leslie WD, Moayyeri A, Sadatsafavi M, Wang L.
J Clin Densitom. 2007 Oct-Dec;10(4):365-9. [Pubmed link]

Low bone mineral density and fracture burden in postmenopausal women.
Cranney A, Jamal SA, Tsang JF, Josse RG, Leslie WD.
CMAJ. 2007 Sep 11;177(6):575-80. [PubMed link]

Single-site vs multisite bone density measurement for fracture prediction.
Leslie WD, Lix LM, Tsang JF, Caetano PA; Manitoba Bone Density Program.
Arch Intern Med. 2007 Aug 13-27;167(15):1641-7. [PubMed link]

Exclusion of focal vertebral artifacts from spine bone densitometry and fracture prediction: a comparison of expert physicians, three computer algorithms, and the minimum vertebra.
Tsang JF, Leslie WD.
J Bone Miner Res. 2007 Jun;22(6):789-98. [PubMed link]

Comparative effects of densitometric and absolute fracture risk classification systems on projected intervention rates in postmenopausal women.
Leslie WD, Siminoski K, Brown JP.
J Clin Densitom. 2007 Apr-Jun;10(2):124-31. [PubMed link]

Clinical risk factors for fracture in postmenopausal Canadian women: a population-based prevalence study.
Leslie WD, Anderson WA, Metge CJ, Manness LJ; Maximizing Osteoporosis Management in Manitoba Steering Committee.
Bone. 2007 Apr;40(4):991-6. [PubMed link]

Number of osteoporotic sites and fracture risk assessment: a cohort study from the Manitoba Bone Density Program.
Leslie WD, Tsang JF, Caetano PA, Lix LM; for the Manitoba Bone Density Program.
J Bone Miner Res. 2007 Mar;22(3):476-83. [PubMed link]

The effect of socioeconomic status on bone density testing in a public health-care system.
Demeter S, Leslie WD, Lix L, MacWilliam L, Finlayson GS, Reed M.
Osteoporos Int. 2007 Feb;18(2):153-8. [PubMed link]

Effectiveness of bone density measurement for predicting osteoporotic fractures in clinical practice.
Leslie WD, Tsang JF, Caetano PA, Lix LM; Manitoba Bone Density Program.
J Clin Endocrinol Metab. 2007 Jan;92(1):77-81. [PubMed link]

Minimum sample size requirements for bone density precision assessment produce inconsistency in clinical monitoring.
Leslie WD, Moayyeri A; For the Manitoba Bone Density Program.
Osteoporos Int. 2006 Nov;17(11):1673-80. [PubMed link]

The importance of spectrum bias on bone density monitoring in clinical practice.
Leslie WD; Manitoba Bone Density Program.
Bone. 2006 Aug;39(2):361-8. [PubMed link]

The impact of bone area on short-term bone density precision.
Leslie WD; Manitoba Bone Density Program.
J Clin Densitom. 2006 Apr-Jun;9(2):150-3. [PubMed link]

The impact of hip subregion reference data on osteoporosis diagnosis.
Leslie WD, Caetano PA, Roe EB.
Osteoporos Int. 2005 Dec;16(12):1669-74. [PubMed link]

Construction and validation of a population-based bone densitometry database.
Leslie WD, Caetano PA, Macwilliam LR, Finlayson GS.
J Clin Densitom. 2005 Spring;8(1):25-30. [PubMed link]

A population-based study of osteoporosis testing and treatment following introduction of a new bone densitometry service.
Leslie WD, MacWilliam L, Lix L, Caetano P, Finlayson GS.
Osteoporos Int. 2005 Jul;16(7):773-82. [PubMed link]

Bone density monitoring with the total hip site: time for a re-evaluation?
Leslie WD, Ward LM.
J Clin Densitom. 2004 Fall;7(3):269-74. [PubMed link]

Establishing a regional bone density program: lessons from the Manitoba experience.
Leslie WD, Metge C.
J Clin Densitom. 2003 Fall;6(3):275-82. [PubMed link]

Contribution of clinical risk factors to bone density-based absolute fracture risk assessment in postmenopausal women.
Leslie WD, Metge C, Ward L.
Osteoporos Int. 2003 Jun;14(4):334-8. [PubMed link]

Bone mineral density testing in healthy postmenopausal women. The role of clinical risk factor assessment in determining fracture risk.
Leslie WD, Metge C, Salamon EA, Yuen CK.
J Clin Densitom. 2002 Summer;5(2):117-30. [PubMed link]