SUNDAE: The Southampton DXA Study – Gathering Real-World Data on bone health

Lay Description

The Southampton DXA and Bone Health Study (SUNDAE) is a prospective project designed to establish a large-scale bone health real-world dataset derived from patients attending dual-energy X-ray absorptiometry (DXA) scanning services at University Hospital Southampton (UHS).

Modelled on the internationally recognised Manitoba Bone Mineral Density Cohort [a population-based database tracking bone density tests and long-term health outcomes], SUNDAE will integrate DXA findings, fracture risk assessment, patient reported outcomes, musculoskeletal function [movement] measures, and linked electronic health record (EHR) data to create a comprehensive longitudinal research resource embedded within routine NHS care. The project aims to improve understanding of osteoporosis and fracture risk across diverse patient populations, with a particular focus on multimorbidity, socioeconomic deprivation, ethnicity, and health inequalities. A further objective is the digitalisation of fracture risk factor collection, quality of life assessments, and musculoskeletal function questionnaires currently used clinically within rheumatology-led bone health and fracture liaison services. Initial analyses will focus on the burden and clustering of long-term comorbidities in patients with osteoporosis and low bone mineral density (BMD), alongside their relationship with fracture outcomes, musculoskeletal function, and quality of life.

Public Benefit Statement

SUNDAE will generate one of the largest longitudinal bone health datasets in the UK, providing a major new infrastructure for musculoskeletal research embedded within routine NHS care.

The dataset will improve understanding of osteoporosis in the context of multimorbidity, ageing, socioeconomic deprivation, and ethnicity, supporting more equitable approaches to fracture prevention and bone health management. Integration of digital clinical assessment tools into routine DXA pathways will improve efficiency and standardisation of data capture across rheumatology and fracture liaison services while reducing duplication of clinical documentation. Linkage with longitudinal healthcare records will allow real-world evaluation of fracture outcomes, disease progression, healthcare utilisation, and long-term comorbidity trajectories.

In the longer term, SUNDAE will provide a scalable platform for multicentre collaboration (with initial collaborations in progress with Manchester and Sheffield hospitals) and future national studies investigating personalised fracture risk prediction and targeted musculoskeletal interventions.