ORIGINAL ARTICLE Predictive ability of heel quantitative ultrasound for incident fractures: an individual-level meta-analysis E. V. McCloskey & J. A. Kanis & A. Odén & N. C. Harvey & D. Bauer & J. González-Macias & D. Hans & S. Kaptoge & M. A. Krieg & T. Kwok & F. Marin & A. Moayyeri & E. Orwoll & C. Gluёr & H. Johansson Received: 9 December 2014 /Accepted: 6 February 2015 # International Osteoporosis Foundation and National Osteoporosis Foundation 2015 Abstract Summary The relationship between bone quantitative ultra- sound (QUS) and fracture risk was estimated in an individual level data meta-analysis of 9 prospective studies of 46,124 individuals and 3018 incident fractures. Low QUS is associ- ated with an increase in fracture risk, including hip fracture. The association with osteoporotic fracture decreases with time. Introduction The aim of this meta-analysis was to investigate the association between parameters of QUS and risk of fracture. Methods In an individual-level analysis, we studied partici- pants in nine prospective cohorts from Asia, Europe and North America. Heel broadband ultrasonic attenuation (BUA dB/ MHz) and speed of sound (SOS m/s) were measured at base- line. Fractures during follow-up were collected by self-report E. V. McCloskey (*) Academic Unit of Bone Metabolism and Mellanby Centre for Bone Research, University of Sheffield, Metabolic Bone Centre, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK e-mail: e.v.mccloskey@sheffield.ac.uk J. A. Kanis Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK A. Odén Consulting Statistician, Gothenburg, Sweden N. C. Harvey MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK D. Bauer Division of General Internal Medicine, UCSF School of Medicine, 185 Berry Street W, San Francisco, CA 94143, USA J. González-Macias Department of Medicine, University of Cantabria, Santander, Spain J. González-Macias Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla and Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Santander, Spain D. Hans Centre for Bone Diseases, University Hospital, Lausanne, Switzerland S. Kaptoge Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK M. A. Krieg Lausanne University Hospital, Lausanne, Switzerland T. Kwok Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong F. Marin Lilly Research Centre, Windlesham, UK A. Moayyeri Department of Twin Research and Genetic Epidemiology, King’ s College London, London, UK E. Orwoll School of Medicine, Oregon Health & Science University, Portland, OR, USA C. Gluёr Sektion Biomedizinische Bildgebung, Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Lubeck, Germany H. Johansson Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK Osteoporos Int DOI 10.1007/s00198-015-3072-7