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A surrogate FRAX model for Pakistan

A surrogate FRAX model for Pakistan
A surrogate FRAX model for Pakistan
Summary: a surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan.

Introduction: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.

Objective: this paper describes the development and characteristics of a surrogate FRAX model for Pakistan.

Methods: the FRAX model used the ethnic-specific incidence of hip fracture in Indian men and women living in Singapore, combined with the death risk for Pakistan.

Results: the surrogate model gave somewhat lower 10-year fracture probabilities for men and women at all ages compared to the model for Indians from Singapore, reflecting a higher mortality risk in Pakistan. There were very close correlations in fracture probabilities between the surrogate and authentic models (r ≥ 0.998) so that the use of the Pakistan model had little impact on the rank order of risk. It was estimated that 36,524 hip fractures arose in 2015 in individuals over the age of 50 years in Pakistan, with a predicted increase by 214% to 114,820 in 2050.

Conclusion: the surrogate FRAX model for Pakistan provides an opportunity to determine fracture probability within the Pakistan population and help guide decisions about treatment.
10.1007%2Fs11657-021-00894-w
1862-3522
Naureen, G.
418b2b80-2a5c-4b0a-a252-0e180c88c8a8
Johansson, H.
05aa5476-bcb9-4b97-905e-00f1dfd9d691
Iqbal, R.
06a3cdc4-9f1a-45e7-b5b6-a40e5fca4ff2
Jafri, L.
168bc5dc-269c-4907-8475-e7fcd409a45f
Khan, AH
fb2a7c0c-e4af-404a-8f9e-0b59ea3cdd4a
Umer, M.
c3c436ba-a25c-4ce8-8110-da09000eecbb
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Vandenput, Lisbeth
51275083-bd2d-4d28-9b3b-f07c4d55aeb8
Lorentzon, M.
11692e10-5916-4bb5-86c5-3ff9ccd77af6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
McCloskey, E.V.
38518227-db8f-4a53-88a6-462f469151de
Kanis, J.A,
52c2c5a7-a17a-49dd-9b2a-30b5a1750a5d
Naureen, G.
418b2b80-2a5c-4b0a-a252-0e180c88c8a8
Johansson, H.
05aa5476-bcb9-4b97-905e-00f1dfd9d691
Iqbal, R.
06a3cdc4-9f1a-45e7-b5b6-a40e5fca4ff2
Jafri, L.
168bc5dc-269c-4907-8475-e7fcd409a45f
Khan, AH
fb2a7c0c-e4af-404a-8f9e-0b59ea3cdd4a
Umer, M.
c3c436ba-a25c-4ce8-8110-da09000eecbb
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Vandenput, Lisbeth
51275083-bd2d-4d28-9b3b-f07c4d55aeb8
Lorentzon, M.
11692e10-5916-4bb5-86c5-3ff9ccd77af6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
McCloskey, E.V.
38518227-db8f-4a53-88a6-462f469151de
Kanis, J.A,
52c2c5a7-a17a-49dd-9b2a-30b5a1750a5d

Naureen, G., Johansson, H., Iqbal, R., Jafri, L., Khan, AH, Umer, M., Liu, Enwu, Vandenput, Lisbeth, Lorentzon, M., Harvey, Nicholas, McCloskey, E.V. and Kanis, J.A, (2021) A surrogate FRAX model for Pakistan. Archives of Osteoporosis, 16, [34]. (doi:10.1007%2Fs11657-021-00894-w).

Record type: Article

Abstract

Summary: a surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan.

Introduction: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.

Objective: this paper describes the development and characteristics of a surrogate FRAX model for Pakistan.

Methods: the FRAX model used the ethnic-specific incidence of hip fracture in Indian men and women living in Singapore, combined with the death risk for Pakistan.

Results: the surrogate model gave somewhat lower 10-year fracture probabilities for men and women at all ages compared to the model for Indians from Singapore, reflecting a higher mortality risk in Pakistan. There were very close correlations in fracture probabilities between the surrogate and authentic models (r ≥ 0.998) so that the use of the Pakistan model had little impact on the rank order of risk. It was estimated that 36,524 hip fractures arose in 2015 in individuals over the age of 50 years in Pakistan, with a predicted increase by 214% to 114,820 in 2050.

Conclusion: the surrogate FRAX model for Pakistan provides an opportunity to determine fracture probability within the Pakistan population and help guide decisions about treatment.

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Pakistan FRAX v3 - Accepted Manuscript
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More information

Accepted/In Press date: 15 January 2021
e-pub ahead of print date: 17 February 2021

Identifiers

Local EPrints ID: 447242
URI: http://eprints.soton.ac.uk/id/eprint/447242
ISSN: 1862-3522
PURE UUID: 3582b4ed-8101-46dd-ae28-694eff929d61
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 05 Mar 2021 17:31
Last modified: 07 Jul 2021 01:40

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Contributors

Author: G. Naureen
Author: H. Johansson
Author: R. Iqbal
Author: L. Jafri
Author: AH Khan
Author: M. Umer
Author: Enwu Liu
Author: Lisbeth Vandenput
Author: M. Lorentzon
Author: Nicholas Harvey ORCID iD
Author: E.V. McCloskey
Author: J.A, Kanis

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