An assessment of intervention thresholds for high fracture risk in Chile
An assessment of intervention thresholds for high fracture risk in Chile
Summary: assessment and treatment pathways using FRAX-based intervention thresholds in Chile can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk.
Purpose: the aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Chile based on major osteoporotic fracture (MOF) probabilities derived from FRAX®.
Methods: intervention and assessment thresholds were derived using methods adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Chile. Age-dependent and hybrid assessment and intervention thresholds were applied to 1998 women and 1122 men age 50 years or more drawn from participants in the National Health Survey 2016–2017.
Results: approximately 12% of men and women had a prior fragility fracture and would be eligible for treatment for this reason. Using age-dependent thresholds, an additional 2.6% of women (0.3% of men) were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended in 5% of men and 38% of women. With hybrid thresholds, an additional 13% of women (3.6% of men) were eligible for treatment and BMD recommended in 11% of men and 42% of women.
Conclusion: the application of hybrid intervention thresholds ameliorates the disparity in fracture probabilities seen with age-dependent thresholds. Probability-based assessment of fracture risk, including the use of the hybrid intervention thresholds for Chile, is expected to help guide decisions about treatment.
FRAX, Fracture risk assessment, Intervention threshold, Osteoporosis
11
Gavilanez, Enrique Lopez
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Luis, Imaicela N.
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Mario, Navarro G.
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Johansson, Helena
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Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Vandenput, Liesbeth
0910d143-4b58-4579-82b0-3810272f1814
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
17 December 2022
Gavilanez, Enrique Lopez
11d3668e-ecb1-493c-80df-579d9153a686
Luis, Imaicela N.
d10f1570-baf3-4abc-b588-747f62869bb2
Mario, Navarro G.
68382688-0e3f-4430-8812-fd84b5e56ca1
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Vandenput, Liesbeth
0910d143-4b58-4579-82b0-3810272f1814
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Gavilanez, Enrique Lopez, Luis, Imaicela N., Mario, Navarro G., Johansson, Helena, Harvey, Nicholas C., Lorentzon, Mattias, Liu, Enwu, Vandenput, Liesbeth, McCloskey, Eugene V. and Kanis, John A.
(2022)
An assessment of intervention thresholds for high fracture risk in Chile.
Archives of Osteoporosis, 18 (1), .
(doi:10.1007/s11657-022-01198-3).
Abstract
Summary: assessment and treatment pathways using FRAX-based intervention thresholds in Chile can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk.
Purpose: the aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Chile based on major osteoporotic fracture (MOF) probabilities derived from FRAX®.
Methods: intervention and assessment thresholds were derived using methods adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Chile. Age-dependent and hybrid assessment and intervention thresholds were applied to 1998 women and 1122 men age 50 years or more drawn from participants in the National Health Survey 2016–2017.
Results: approximately 12% of men and women had a prior fragility fracture and would be eligible for treatment for this reason. Using age-dependent thresholds, an additional 2.6% of women (0.3% of men) were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended in 5% of men and 38% of women. With hybrid thresholds, an additional 13% of women (3.6% of men) were eligible for treatment and BMD recommended in 11% of men and 42% of women.
Conclusion: the application of hybrid intervention thresholds ameliorates the disparity in fracture probabilities seen with age-dependent thresholds. Probability-based assessment of fracture risk, including the use of the hybrid intervention thresholds for Chile, is expected to help guide decisions about treatment.
Text
Basede cohort report vOSIN R1
- Accepted Manuscript
More information
Accepted/In Press date: 1 December 2022
Published date: 17 December 2022
Additional Information:
Funding Information:
This research used information from the Health Surveys for epidemiological surveillance of the Subsecretaría de Salud Pública. The authors are grateful to the Ministry of Health of Chile for having made the database available to us. All the results obtained from the study or research are the responsibility of the authors and in no way compromise the said institution (http://epi.minsal.cl/encuesta-nacional-de-salud-2015-2016/).
Publisher Copyright:
© 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
Keywords:
FRAX, Fracture risk assessment, Intervention threshold, Osteoporosis
Identifiers
Local EPrints ID: 475978
URI: http://eprints.soton.ac.uk/id/eprint/475978
ISSN: 1862-3522
PURE UUID: 69205b85-5c3a-468f-8466-f02601487354
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Date deposited: 03 Apr 2023 16:47
Last modified: 17 Mar 2024 07:37
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Contributors
Author:
Enrique Lopez Gavilanez
Author:
Imaicela N. Luis
Author:
Navarro G. Mario
Author:
Helena Johansson
Author:
Mattias Lorentzon
Author:
Enwu Liu
Author:
Liesbeth Vandenput
Author:
Eugene V. McCloskey
Author:
John A. Kanis
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