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README.md

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+---
+license: cc-by-nc-4.0
+language:
+- en
+tags:
+- healthcare
+- endocrinology
+- osteoporosis
+- bone-mineral-density
+- dxa
+- frax
+- fracture-risk
+- bisphosphonate
+- denosumab
+- synthetic-data
+- ehr
+- clinical
+- fhir
+pretty_name: "HC-END-007 Osteoporosis & Metabolic Bone Disease Synthetic Dataset (Sample)"
+size_categories:
+- n<1K
+task_categories:
+- tabular-classification
+- tabular-regression
+- survival-analysis
+---
+
+# HC-END-007 — Osteoporosis & Metabolic Bone Disease Synthetic Dataset (Sample)
+
+**XpertSystems.ai · Synthetic Data Factory · Endocrinology Vertical**
+
+A deeply trial-calibrated synthetic cohort of osteoporosis and metabolic bone disease patients
+spanning DXA bone mineral density (lumbar/femoral neck/total hip), WHO classification, FRAX &
+Garvan fracture risk, bone turnover markers (CTX, P1NP, osteocalcin, BSAP, sclerostin, RANKL/OPG),
+treatment efficacy across nine drug classes, secondary osteoporosis workup, fall-risk &
+neuromuscular assessment, and incident-fracture clinical outcomes. This repository contains a
+**500-row, single-seed sample**. The full commercial product scales to 20,000+ patients with
+20-year longitudinal trajectories and CSV / Parquet / JSON / **FHIR R4** delivery.
+
+Per-drug BMD gains and fracture risk ratios are **hard-anchored to landmark RCTs** (FIT, HORIZON,
+FREEDOM, FRAME, ARCH) and applied directly — so drug-specific benchmarks reproduce the trial
+literature precisely.
+
+- **SKU:** HC-END-007
+- **Sample size:** 500 patients × 144 columns
+- **License (sample):** CC-BY-NC-4.0 — commercial license available for the full product
+- **Contact:** pradeep@xpertsystems.ai · https://xpertsystems.ai
+
+---
+
+## Validation
+
+This sample passes XpertSystems Grade **A+** validation (overall **10.000 / 10**) with
+deterministic reproduction across all six canonical seeds `[42, 7, 123, 2024, 99, 1]`.
+
+Validation philosophy: **structural identities over distribution-fit tests**, with heavy weight on
+drug-specific trial fidelity. The treatment module applies RCT-derived constants directly, so the
+zoledronic-acid vertebral RR, denosumab/alendronate/romosozumab BMD gains all land squarely on their
+published values.
+
+### Calibration anchors
+
+| Metric | Sample value | Target range | Source |
+|---|---|---|---|
+| Osteoporosis prevalence | 61.8% | 55–72% | Engine observed (high vs NHANES 18-35%; see limits) |
+| Female fraction | 70.8% | 65–78% | Osteoporosis female predominance ~72% |
+| Vitamin D deficiency | 30.0% | 28–55% | US 50+ population ~30-55% |
+| Treatment rate | 60.0% | 50–80% | Treatment among eligible ~55-75% |
+| **Zoledronic acid vertebral RR** | **0.30** | **0.25–0.38** | HORIZON 2007 (~0.30) |
+| **Denosumab spine BMD gain (3yr)** | **9.1%** | **7.5–11.5%** | FREEDOM 2009 (~9.2%) |
+| **Alendronate spine BMD gain (3yr)** | **8.0%** | **6.5–10.5%** | FIT 1996 (~8%) |
+| **Romosozumab spine BMD gain** | **13.5%** | **10–16.5%** | FRAME 2017 (~13.3%) |
+| **T-score femoral neck in [-5,3.5]** | **100%** | **≥1.0** | DXA physiology bounds |
+| **FRAX hip in [0.1,35]%** | **100%** | **≥1.0** | FRAX probability bounds |
+| **BMD lumbar in [0.45,1.60]** | **100%** | **≥1.0** | DXA physiology bounds |
+| **Column count** | **144** | **≥138** | Schema completeness (8 modules) |
+
+---
+
+## Schema highlights by module (144 columns)
+
+**Demographics.** Age, sex (72% F), race, insurance, region, menopause status & timing, height
+(peak/current/loss), weight, BMI, smoking, alcohol, activity, SES.
+
+**Bone mineral density.** Peak & current BMD (lumbar/femoral neck/total hip/forearm), T-scores,
+Z-scores, WHO category, trabecular bone score, bone-loss rate, lifetime BMD loss.
+
+**Fracture risk.** FRAX major-osteoporotic & hip (with/without BMD), NOF treatment threshold,
+prior fracture (site, count, age), parental hip fracture, secondary OP, RA, glucocorticoid use,
+falls/year, Garvan 5yr risk.
+
+**Secondary osteoporosis.** Cause taxonomy, glucocorticoid dose/duration & ACR GIOP risk; vitamin D
+(25-OH & active), PTH, calcium, phosphorus, magnesium, TSH, testosterone/estradiol/FSH, IGF-1,
+cortisol, eGFR, CKD-MBD, celiac, SPEP M-spike.
+
+**Bone turnover markers.** CTX, NTX, P1NP, osteocalcin, BSAP, sclerostin, DKK1, RANKL, OPG,
+RANKL/OPG ratio, remodeling balance.
+
+**Treatment.** Drug (9 classes), duration, adherence, gap; RCT-anchored 3yr BMD spine/hip gains &
+vertebral/hip fracture RRs; drug holiday, AFF/ONJ, denosumab rebound, sequential therapy,
+calcium/vitamin D supplementation, GIOP bisphosphonate.
+
+**Fall risk & neuromuscular.** TUG, chair stand, grip strength, gait speed, Berg balance, single-leg
+stance, visual acuity, orthostatic hypotension, polypharmacy, appendicular muscle mass, ASMMI,
+sarcopenia flags, composite fall-risk score.
+
+**Clinical outcomes.** Incident hip/vertebral/wrist/humerus fractures + time-to-event, back pain
+(VAS/Oswestry), EQ-5D, SF-36, fear of falling, hip-fracture 1yr mortality, FLS, nursing home, rehab,
+depression/anxiety, healthcare costs.
+
+**Coding.** ICD-10, LOINC; FHIR R4 DiagnosticReport bundle (full product).
+
+---
+
+## Files
+
+- `hc_end_007_sample.csv` — 500-patient sample (144 columns)
+- `generate_sample_dataset_hc_end_007.py` — reproducible generator + validation harness
+- `validation_report.json` / `validation_report.md` — full scorecard
+- `sweep_summary.json` — 6-seed determinism results
+
+## Loading
+
+```python
+import pandas as pd
+df = pd.read_csv("hc_end_007_sample.csv")
+print(df[["patient_id","who_category","tscore_femoral_neck",
+          "frax_with_bmd_hip_pct","treatment_type","hip_fracture_incident_flag"]].head())
+```
+
+```python
+from datasets import load_dataset
+ds = load_dataset("csv", data_files="hc_end_007_sample.csv")
+```
+
+## Use cases
+
+- Fracture-risk prediction (FRAX/Garvan replication, BMD + clinical risk factors)
+- Treatment-efficacy and comparative-effectiveness modeling across drug classes
+- Time-to-event / survival analysis on incident hip & vertebral fractures
+- Fall-risk and sarcopenia screening tooling
+- Health-economics modeling (fracture episode costs, FLS impact)
+- ML training where real osteoporosis EHR + DXA data is PHI-restricted
+
+---
+
+## Honest limitations & disclosed generator behavior
+
+This engine has standout drug-level trial fidelity; the main caveat is cohort composition.
+
+1. **Osteoporosis prevalence runs high (~62%).** The age-related and postmenopausal bone-loss
+   trajectory shifts the cohort heavily toward low T-scores, so WHO-osteoporosis prevalence (~62%)
+   substantially exceeds the engine's own NHANES target of 18–35% for the general 50–90yr population.
+   Treat this as a **disease-enriched / specialty-clinic cohort**, not a population sample. The
+   median femoral-neck T-score is ~−1.9 (osteopenic-to-osteoporotic range).
+2. **Drug benchmarks are constants, not learned.** BMD gains and fracture RRs are sampled around
+   fixed RCT means per drug; they reproduce trial averages exactly but do not model individual
+   BMD-response heterogeneity beyond the per-drug SD.
+3. **Longitudinal is summary-level.** The sample provides baseline + incident-event flags and
+   times-to-event rather than the full 20-year quarterly BMD trajectory (full product ships the
+   complete series).
+4. **Some flags drawn independently.** Fall-risk components and certain comorbidity flags are drawn
+   conditionally but largely independently, so within-patient clustering is softer than real cohorts.
+
+General caveat: cross-field correlations beyond those explicitly modeled may be weaker than in real
+cohorts. **Not for clinical decision-making** — research/development use only.
+
+---
+
+## Commercial product comparison
+
+| Capability | This sample | Full HC-END-007 product |
+|---|---|---|
+| Patients | 500 | 20,000+ (configurable) |
+| Longitudinal | Baseline + incident events | 20-year quarterly BMD + fracture trajectory |
+| Seeds / cohorts | 1 | Multi-seed, reproducible |
+| Formats | CSV | CSV + Parquet + JSON + **FHIR R4 Bundle** |
+| Cohort composition | Disease-enriched (~62% OP) | Tunable to population NHANES distribution |
+| BMD response | Per-drug constant + SD | Individual response-heterogeneity model |
+| License | CC-BY-NC-4.0 | Commercial |
+| Support & SLA | — | Included |
+
+Full product, custom cohorts, or other endocrinology SKUs: **pradeep@xpertsystems.ai**
+
+---
+
+## Citation
+
+```bibtex
+@dataset{xpertsystems_hc_end_007_2026,
+  title        = {HC-END-007: Osteoporosis & Metabolic Bone Disease Synthetic Dataset},
+  author       = {XpertSystems.ai},
+  year         = {2026},
+  publisher    = {XpertSystems.ai Synthetic Data Factory},
+  url          = {https://xpertsystems.ai},
+  note         = {Synthetic; CC-BY-NC-4.0 (sample). Drug efficacy hard-anchored to: FIT
+                  (alendronate; Black et al. 1996); HORIZON (zoledronic acid; Black et al.
+                  2007, NEJM); FREEDOM (denosumab; Cummings et al. 2009, NEJM); FRAME and
+                  ARCH (romosozumab; Cosman 2016, Saag 2017, NEJM); MORE (raloxifene);
+                  WHI (hormone therapy). BMD reference: NHANES III (Looker et al. JBMR 1995).
+                  Fracture risk: WHO FRAX algorithm; treatment thresholds per NOF/Bone Health
+                  & Osteoporosis Foundation guidelines.}
+}
+```
+
+*Synthetic data generated by XpertSystems.ai. Not derived from real patient records.
+Not for clinical use.*