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FRAX could be adjusted to predict fractures shorter
and longer than 10 years as it effectively predicted incident MOF and hip
fracture up to 15 years.
FRAX predicted incident MOF and hip fracture from 1 to 15 years following baseline assessment. Osteoporosis is one of the serious health concern, causes more than 8.9 million fractures worldwide yearly. To diagnose osteoporosis, doctors generally recommend a bone density scan which measures bone mineral density (BMD). BMD is considered as a standard measure for the osteoporosis diagnosis. One another diagnostic method, FRAX (Fracture Risk Assessment Tool) was found to be very effective in fracture diagnosis on the basis of clinical risk factors. This tool is advantageous for the patients who have low bone mineral density and ten-year risk of hip fracture of ≥3% or major osteoporosis-related fracture (MOF) of ≥20%. This method estimates 10-year probability of hip fracture and MOF. However, its prediction over shorter and longer than 10 years is unclear. To evaluate this evidence scientists conducted a study.
A total of 62,275 women and 6455 men were selected for the study. The selection of participants was done by using a population-based clinical registry for Manitoba, Canada. The age of the participants was around 40 years or older. These participants underwent dual-energy X-ray absorptiometry scans and FRAX scores before trial initiation. After assessing baseline scores, MOF and hip fracture were evaluated up to 15 years. The scientists used linear predicted FRAX scores to estimate an agreement between estimated fracture probability from 1 to 15 years. After this estimation, cumulative fracture probability was figured out. Further, the gradient of risk for incident fracture and FRAX probability was also determined overall and at the intervals of 5-years.
The evaluation of incident MOF and hip fracture done at all time intervals. FRAX evaluated no gradient of risk for MOF even for years >10. However, the little lower risk was seen for hip fracture evaluation in years >10 vs years <5, though HRs remained high. Further, observed vs predicted FRAX probabilities associations showed linear agreement. This linear agreement noticed nearly perfect among women for MOF predictions. But for hip fracture prediction, the case is not the same. Among women, slightly higher deviations from linearity with a fracture event were noticed after 10 years. These predictions were done by using both FRAX and BMD. However, the limitation of this operation was that results were vigorous to moderate differences in mortality rates and large differences in fracture rates.
Except for simulations, FRAX method of diagnosis is very efficient in
predicting incident MOF and hip fracture up to 15 years and can be adjusted to
evaluate fracture over time periods shorter and longer term than 10 years.
Osteoporos Int. 2017 Jun 7.
FRAX for fracture prediction shorter and longer than 10 years: the Manitoba BMD registry
W.D.Leslie et al.
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