US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50–64 years

Bansal, Shiveta; Pecina, Jennifer L; Merry, Stephen; Kennel, Kurt A.; Maxson, Julie; Quigg, Stephanie M; Thacher, Tom D.

doi:10.1007/s00198-015-3026-0

Cited by 20 publications

(18 citation statements)

References 10 publications

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“…0.71-0.80; I 2 = 93.2%; 7 studies [7798 participants]); for the Male Osteoporosis Risk Estimation Score, the pooled AUC was 0.80 (95% CI, 0.71-0.88; I 2 = 97.6%; 3 studies [4828 participants]). AUCs for FRAX could not be pooled but ranged from 0.58 26 to 0.82. 26 AUCs in younger women (<65 years) varied from 0.58 26 to 0.85.…”

Section: Clinical Risk Assessmentsmentioning

confidence: 99%

Screening to Prevent Osteoporotic Fractures

Viswanathan

Reddy

Berkman

et al. 2018

JAMA

156

134

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Section: Clinical Risk Assessmentsmentioning

confidence: 99%

Screening to Prevent Osteoporotic Fractures

Viswanathan

Reddy

Berkman

et al. 2018

JAMA

156

134

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“…7,22 Accordingly, we found that postmenopausal women aged 50 to 64 who developed a screening-level FRAX were unlikely to have a hip or clinical vertebral fracture before age 65. Like past studies, 7,8 our results do not support routine use of FRAX to identify candidates for screening in postmenopausal women aged 50 to 64.…”

Section: Discussionmentioning

confidence: 79%

Time to Clinically Relevant Fracture Risk Scores in Postmenopausal Women

Gourlay

Overman

Fine

et al. 2017

The American Journal of Medicine

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Background Clinical practice guidelines recommend use of fracture risk scores for screening and pharmacologic treatment decisions. The timing of occurrence of treatment-level (according to 2014 National Osteoporosis Foundation guidelines) or screening-level (according to 2011 US Preventive Services Task Force guidelines) fracture risk scores has not been estimated in postmenopausal women. Methods We conducted a retrospective competing risk analysis of new occurrence of treatment-level and screening-level fracture risk scores in postmenopausal women aged 50 and older, before receipt of pharmacologic treatment and before first hip or clinical vertebral fracture. Results In 54,280 postmenopausal women aged 50 to 64 without a bone mineral density test, the time for 10% to develop a treatment-level FRAX® could not be estimated accurately because of rare incidence of treatment-level scores. In 6096 women who had FRAX scores calculated with bone mineral density, the estimated unadjusted time to treatment-level FRAX ranged from 7.6 years (95% CI, 6.6, 8.7) for those aged 65 to 69 to 5.1 years (95% CI, 3.5, 7.5) for those aged 75 to 79 at baseline. Of 17,967 women aged 50 to 64 with a screening-level FRAX at baseline, 100 (0.6%) experienced a hip or clinical vertebral fracture by age 65. Conclusions Postmenopausal women with sub-threshold fracture risk scores at baseline were unlikely to develop a treatment-level FRAX score between ages 50 and 64. After age 65, the increased incidence of treatment-level fracture risk scores, osteoporosis and major osteoporotic fracture supports more frequent consideration of FRAX and bone mineral density testing.

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“…The FRAX score (https://www. shef.ac.uk), while carrying some limitations and having a lower sensitivity and specificity for younger patients [87], is validated, readily available, and easily administered to patients. However, the actual utilization of FRAX is poor, with the USA performing 11,807 calculations per 1 million people over the age of 50 [88].…”

Section: Denosumabmentioning

confidence: 99%

Osteoporosis: a discussion on the past 5 years

Schweser

Crist

2017

Curr Rev Musculoskelet Med

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Purpose of the review The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. -Ultrasound may be cost-effective for diagnosis. Summary Understanding of osteoporosis has come a long way in the medical community, but the translation to the lay community has lagged behind. Patients often take a laissezfaire attitude toward osteoporosis that can affect compliance. Information read by patients often focuses on complications, such as atypical femur fractures and myocardial infarctions. It is essential for providers to be able to discuss these issues with patients. Newer medications and more cost-effective diagnostic tests exist, but availability may be limited. FLS are effective, but the most cost-effective model for therapy still eludes us. Areas for further investigation include FLS models, the effectiveness of vitamin supplementation, and more ubiquitous and cost-effective diagnostic tools.

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US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50–64 years

Abstract: We found that the USPSTF-recommended MOF risk threshold of 9.3 % for osteoporosis screening in women ages 50-64 years old has a low sensitivity to detect osteoporosis.

Cited by 20 publications

References 10 publications

Screening to Prevent Osteoporotic Fractures

Screening to Prevent Osteoporotic Fractures

Time to Clinically Relevant Fracture Risk Scores in Postmenopausal Women

Osteoporosis: a discussion on the past 5 years

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