Defining High Risk of Osteoporotic Fracture

Casado, Enrique; Malouf, Jorge; Caamaño, Manuel; Salas, Esteban M. Martínez; Sánchez‐Bursón, Juan; Rentero, Maria Luz; Herrero‐Beaumont, Gabriel

doi:10.1097/rhu.0b013e318227a106

Cited by 3 publications

(2 citation statements)

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“…Our results offer health professionals information about the clinical performance of FRAX without BMD in a real-world setting to stimulate the evaluation of fracture risk in daily clinical practice. The relevance of using FRAX thresholds to determine high fracture risk criteria provides significant opportunities for improving patient care and preventing future fragility fractures 42 . Field of fracture prevention research is extensive, and there is still room for improvement.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of FRAX Performance Without Bone Mineral Density Calibrated for Mexico to Recognize Women at Risk of Fragility Fractures in Routine Clinical Care

Horta-Baas

2020

J Clin Rheumatol

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To evaluate FRAX clinical performance without bone mineral density (BMD) to approach people with fracture risk.Methods: A cross-sectional study was carried out from July 2012 to February 2020 at outpatient clinic of rheumatology in 2 public hospitals. Postmenopausal women between 40 and 90 years of age were chosen if no previous osteoporosis treatment was received and had femoral neck BMD determination. Clinical performance of FRAX without BMD was evaluated using agreement and diagnostic test statistics.Results: Four hundred seventy-seven women with a mean age of 62.85 years were included. FRAX without BMD classified 46.03% of them at low risk, 45.82% intermediate risk, and 8.16% high risk. When BMD was included, 17.19% of them revealed high risk. Not incorporating BMD value in the risk assessed a higher percentage of error in the fracture risk classification in high-risk patients; otherwise, including BMD reclassified it as risk below treatment threshold in 20.51% of the patients. The percentage of agreement between the recommendations based on FRAX with and without BMD was 94.98%. Agreement between FRAX score with or without BMD was good to very good (κ = 0.79, Gwet = 0.93). FRAX without BMD presented a positive predictive value of 79.5% and negative predictive value of 97.7%.Conclusions: FRAX without BMD correctly classified most women evaluated, primarily low-risk women. In order to identify accurately women at high fracture risk, it would be advisable to determine the BMD in women with moderate to high risk of FRAX without BMD.

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Section: Discussionmentioning

confidence: 99%

“…The relevance of using FRAX thresholds to determine high fracture risk criteria provides significant opportunities for improving patient care and preventing future fragility fractures. 42 Field of fracture prevention research is extensive, and there is still room for improvement.…”

Section: Discussionmentioning

confidence: 99%