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FRAX and ethnicity

FRAX and ethnicity
FRAX and ethnicity
A recent article from the New England Journal of Medicine questioned the use of race or ethnicity in assessment algorithms [1]. In the case of osteoporosis, the authors noted that the US FRAX calculator returns a lower fracture risk for women who are Black (by a factor of 0.43), Asian (0.50) or Hispanic (0.53). They conclude that the lower risk for Black, Asian and minority ethnic (BAME) women may delay intervention with osteoporosis therapy. The New York Times goes further in stating that with FRAX (sic) black women end up having a score that makes them less likely to be prescribed osteoporosis medication than white women who are similar in all other respects [2].
In the case of osteoporosis and FRAX, the authors do not appear to have grasped the reality of fracture epidemiology and risk assessment. In this editorial, we set out the key messages from the epidemiology of fracture globally, key considerations in building risk assessment tools, the specific contribution of race/ethnicity and practical considerations related to any move to alter race/ethnicity categorisation or remove them entirely.
0937-941X
2063–2067
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dawson-Hughes, Bess
a9df73df-dff4-4a37-b358-abff8d5d2c2d
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Reginster, Jean Yves
33684a35-87f7-4b8d-bb91-4da2b809f855
Rizzoli, Rene
e02c0d92-6da1-430c-a669-0c20e94a850a
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dawson-Hughes, Bess
a9df73df-dff4-4a37-b358-abff8d5d2c2d
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Reginster, Jean Yves
33684a35-87f7-4b8d-bb91-4da2b809f855
Rizzoli, Rene
e02c0d92-6da1-430c-a669-0c20e94a850a

Kanis, John A., Cooper, Cyrus, Dawson-Hughes, Bess, Harvey, Nicholas, Johansson, Helena, Lorentzon, Mattias, McCloskey, Eugene V., Reginster, Jean Yves and Rizzoli, Rene (2020) FRAX and ethnicity. Osteoporosis International, 31, 2063–2067. (doi:10.1007/s00198-020-05631-6).

Record type: Article

Abstract

A recent article from the New England Journal of Medicine questioned the use of race or ethnicity in assessment algorithms [1]. In the case of osteoporosis, the authors noted that the US FRAX calculator returns a lower fracture risk for women who are Black (by a factor of 0.43), Asian (0.50) or Hispanic (0.53). They conclude that the lower risk for Black, Asian and minority ethnic (BAME) women may delay intervention with osteoporosis therapy. The New York Times goes further in stating that with FRAX (sic) black women end up having a score that makes them less likely to be prescribed osteoporosis medication than white women who are similar in all other respects [2].
In the case of osteoporosis and FRAX, the authors do not appear to have grasped the reality of fracture epidemiology and risk assessment. In this editorial, we set out the key messages from the epidemiology of fracture globally, key considerations in building risk assessment tools, the specific contribution of race/ethnicity and practical considerations related to any move to alter race/ethnicity categorisation or remove them entirely.

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Ethnicity ms v2 - Accepted Manuscript
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Accepted/In Press date: 1 September 2020
e-pub ahead of print date: 4 September 2020

Identifiers

Local EPrints ID: 443802
URI: http://eprints.soton.ac.uk/id/eprint/443802
ISSN: 0937-941X
PURE UUID: ed2011bd-6b0b-4696-9b59-394b0296d43d
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 14 Sep 2020 16:30
Last modified: 27 Oct 2021 04:01

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Contributors

Author: John A. Kanis
Author: Cyrus Cooper ORCID iD
Author: Bess Dawson-Hughes
Author: Nicholas Harvey ORCID iD
Author: Helena Johansson
Author: Mattias Lorentzon
Author: Eugene V. McCloskey
Author: Jean Yves Reginster
Author: Rene Rizzoli

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