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Fracture experience among participants from the FROCAT study: what thresholding is appropriate using the FRAX tool?

Fracture experience among participants from the FROCAT study: what thresholding is appropriate using the FRAX tool?
Fracture experience among participants from the FROCAT study: what thresholding is appropriate using the FRAX tool?
Objective

To perform an external validation of FRAX algorithm thresholds for reporting level of risk of fracture in Spanish women (low <5%; intermediate ?5% and <7.5%; high ?7.5%) taken from a prospective cohort “FRIDEX”.

Methods

A retrospective study of 1090 women aged ?40 and ?90 years old obtained from the general population (FROCAT cohort). FRAX was calculated with data registered in 2002. All fractures were validated in 2012. Sensitivity analysis was performed.

Results

When analyzing the cohort (884) excluding current or past anti osteoporotic medication (AOM), using our nominated thresholds, among the 621 (70.2%) women at low risk of fracture, 5.2% [CI95%: 3.4–7.6] sustained a fragility fracture; among the 99 at intermediate risk, 12.1% [6.4–20.2]; and among the 164 defined as high risk, 15.9% [10.6–24.2]. Sensitivity analysis against model risk stratification FRIDEX of FRAX Spain shows no significant difference. By including 206 women with AOM, the sensitivity analysis shows no difference in the group of intermediate and high risk and minimal differences in the low risk group.

Conclusions

Our findings support and validate the use of FRIDEX thresholds of FRAX when discussing the risk of fracture and the initiation of therapy with patients.
osteoporotic fractures, FRAX thresholds
0378-5122
1-7
Azagra, R.
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Zwart, M.
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Aguyé, A.
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Martín-Sánchez, J.C.
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Casado, E.
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Díaz-Herrera, M.A.
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Moriña, D.
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Cooper, C.
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Díez-Pérez, A.
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Dennison, E.M.
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Azagra, R.
e2cf4127-5c23-4b03-933b-352532be22c0
Zwart, M.
addf1781-a151-46ef-9988-d3e56608f2be
Aguyé, A.
3a7f14cb-aa41-4da0-a57a-3b62484d8460
Martín-Sánchez, J.C.
db1c74b5-3fab-4187-ad95-d65dd9147a67
Casado, E.
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Díaz-Herrera, M.A.
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Moriña, D.
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Cooper, C.
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Díez-Pérez, A.
350015e9-90b8-4384-988b-2013fe3ee78c
Dennison, E.M.
b0d66fa2-38df-4d0b-87c8-43d5ee9a3b51

Azagra, R., Zwart, M., Aguyé, A., Martín-Sánchez, J.C., Casado, E., Díaz-Herrera, M.A., Moriña, D., Cooper, C., Díez-Pérez, A. and Dennison, E.M. (2015) Fracture experience among participants from the FROCAT study: what thresholding is appropriate using the FRAX tool? Maturitas, 1-7. (doi:10.1016/j.maturitas.2015.10.002). (PMID:26546077)

Record type: Article

Abstract

Objective

To perform an external validation of FRAX algorithm thresholds for reporting level of risk of fracture in Spanish women (low <5%; intermediate ?5% and <7.5%; high ?7.5%) taken from a prospective cohort “FRIDEX”.

Methods

A retrospective study of 1090 women aged ?40 and ?90 years old obtained from the general population (FROCAT cohort). FRAX was calculated with data registered in 2002. All fractures were validated in 2012. Sensitivity analysis was performed.

Results

When analyzing the cohort (884) excluding current or past anti osteoporotic medication (AOM), using our nominated thresholds, among the 621 (70.2%) women at low risk of fracture, 5.2% [CI95%: 3.4–7.6] sustained a fragility fracture; among the 99 at intermediate risk, 12.1% [6.4–20.2]; and among the 164 defined as high risk, 15.9% [10.6–24.2]. Sensitivity analysis against model risk stratification FRIDEX of FRAX Spain shows no significant difference. By including 206 women with AOM, the sensitivity analysis shows no difference in the group of intermediate and high risk and minimal differences in the low risk group.

Conclusions

Our findings support and validate the use of FRIDEX thresholds of FRAX when discussing the risk of fracture and the initiation of therapy with patients.

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Accepted/In Press date: 2 October 2015
e-pub ahead of print date: 21 October 2015
Keywords: osteoporotic fractures, FRAX thresholds
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 383691
URI: http://eprints.soton.ac.uk/id/eprint/383691
ISSN: 0378-5122
PURE UUID: 00dc8ebb-a09f-4b02-8d34-9e63c3df80b3
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 09 Nov 2015 11:49
Last modified: 17 Dec 2019 01:56

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Contributors

Author: R. Azagra
Author: M. Zwart
Author: A. Aguyé
Author: J.C. Martín-Sánchez
Author: E. Casado
Author: M.A. Díaz-Herrera
Author: D. Moriña
Author: C. Cooper ORCID iD
Author: A. Díez-Pérez
Author: E.M. Dennison

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