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Assessing the risk of osteoporotic fractures: the Ecuadorian FRAX model

Assessing the risk of osteoporotic fractures: the Ecuadorian FRAX model
Assessing the risk of osteoporotic fractures: the Ecuadorian FRAX model

Summary: The FRAX tool incorporates data on the incidence of fractures and mortality in each country. The epidemiology of fractures changes over time, this makes it necessary to update the specific FRAX model of each population. It is shown that there are differences between old and new FRAX models in older individuals. 

Purpose: A new FRAX® model for Ecuador was released online in April 2019. This paper describes the data used to build the revised model, its characteristics, and how intervention and assessment thresholds were constructed. 

Methods: The national rates of hip fracture incidence standardized by age and sex from the age of 40 years for 2016 were used to synthesize a FRAX model for Ecuador. For other major fractures, Ecuadorian incidence rates were calculated using ratios obtained in Malmö, Sweden, for other major osteoporotic fractures. The new FRAX model was compared with the previous model released in 2012. Assessment and intervention thresholds were based on age-specific probabilities of a major osteoporotic fracture equivalent to women with a previous fracture. 

Results: Fracture incidence rates increase with age. The probability of hip or major fractures at 10 years increased in patients with a clinical risk factor, lower BMI, female sex, a higher age, and a lower BMD T-score. Compared to the previous model, the new FRAX model gave similar 10-year fracture probabilities in men and women age less than70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the two models (> 0.99) so that the revision had little impact on the rank order of risk. 

Conclusions: The FRAX tool provides a country-specific fracture prediction model for Ecuador. This update of the model is based on the original FRAX methodology, which has been validated externally in several independent cohorts. The FRAX model is an evolving tool that is being continuously refined, as the databases of each country are updated with more epidemiological information.

Ecuador, FRAX model, Hip fracture, Osteoporosis
1862-3522
1-8
Lopez Gavilanez, Enrique
0832ae55-a521-4f3e-8ac7-f73b552b8b3f
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
McCloskey, Eugene
3a2fac33-b400-4ae3-a212-04c3c3d2a517
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Segale Bajana, Angel
3ce681e6-a59f-4a3a-ac91-bf7ef0bb3e2d
Marriott Blum, Denisse
f753e7a5-45d1-4ece-a59d-75bbc58dac91
Navarro Grijalva, Mario
c9040e05-cc47-4d6a-8ba1-c44b19aa8ff1
Diaz Curiel, Manuel
c54976ce-a8e2-4495-b4ee-fbb7b8b5711f
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Lopez Gavilanez, Enrique
0832ae55-a521-4f3e-8ac7-f73b552b8b3f
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
McCloskey, Eugene
3a2fac33-b400-4ae3-a212-04c3c3d2a517
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Segale Bajana, Angel
3ce681e6-a59f-4a3a-ac91-bf7ef0bb3e2d
Marriott Blum, Denisse
f753e7a5-45d1-4ece-a59d-75bbc58dac91
Navarro Grijalva, Mario
c9040e05-cc47-4d6a-8ba1-c44b19aa8ff1
Diaz Curiel, Manuel
c54976ce-a8e2-4495-b4ee-fbb7b8b5711f
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d

Lopez Gavilanez, Enrique, Johansson, Helena, McCloskey, Eugene, Harvey, Nicholas C., Segale Bajana, Angel, Marriott Blum, Denisse, Navarro Grijalva, Mario, Diaz Curiel, Manuel and Kanis, John A. (2019) Assessing the risk of osteoporotic fractures: the Ecuadorian FRAX model. Archives of Osteoporosis, 14 (1), 1-8, [93]. (doi:10.1007/s11657-019-0644-8).

Record type: Article

Abstract

Summary: The FRAX tool incorporates data on the incidence of fractures and mortality in each country. The epidemiology of fractures changes over time, this makes it necessary to update the specific FRAX model of each population. It is shown that there are differences between old and new FRAX models in older individuals. 

Purpose: A new FRAX® model for Ecuador was released online in April 2019. This paper describes the data used to build the revised model, its characteristics, and how intervention and assessment thresholds were constructed. 

Methods: The national rates of hip fracture incidence standardized by age and sex from the age of 40 years for 2016 were used to synthesize a FRAX model for Ecuador. For other major fractures, Ecuadorian incidence rates were calculated using ratios obtained in Malmö, Sweden, for other major osteoporotic fractures. The new FRAX model was compared with the previous model released in 2012. Assessment and intervention thresholds were based on age-specific probabilities of a major osteoporotic fracture equivalent to women with a previous fracture. 

Results: Fracture incidence rates increase with age. The probability of hip or major fractures at 10 years increased in patients with a clinical risk factor, lower BMI, female sex, a higher age, and a lower BMD T-score. Compared to the previous model, the new FRAX model gave similar 10-year fracture probabilities in men and women age less than70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the two models (> 0.99) so that the revision had little impact on the rank order of risk. 

Conclusions: The FRAX tool provides a country-specific fracture prediction model for Ecuador. This update of the model is based on the original FRAX methodology, which has been validated externally in several independent cohorts. The FRAX model is an evolving tool that is being continuously refined, as the databases of each country are updated with more epidemiological information.

Full text not available from this repository.

More information

Accepted/In Press date: 12 August 2019
e-pub ahead of print date: 22 August 2019
Published date: 1 December 2019
Keywords: Ecuador, FRAX model, Hip fracture, Osteoporosis

Identifiers

Local EPrints ID: 436162
URI: http://eprints.soton.ac.uk/id/eprint/436162
ISSN: 1862-3522
PURE UUID: 4e2434e4-6a74-48c3-bc2b-db709ab557d3
ORCID for Nicholas C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 29 Nov 2019 17:31
Last modified: 07 Oct 2020 01:49

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