The utility and limitations of FRAX: A us perspective

被引:109
作者
Silverman S.L. [1 ]
Calderon A.D. [1 ]
机构
[1] Beverly Hills, CA 90211
关键词
Fracture; Fracture risk; FRAX; Osteoporosis;
D O I
10.1007/s11914-010-0032-1
中图分类号
学科分类号
摘要
The FRAX calculator is a major achievement in terms of our understanding of measuring fracture risk. Along with being an easily accessible web-based tool, it is the only model based on extensive data on multiple cohorts. FRAX will help clinicians identify individuals who need osteoporosis treatments, while also screening out those who do not require osteoporosis treatments. However, FRAX is limited by a number of factors. Although it is web based, few physicians have the means to access it. It also assumes that body mass index and mortality are constant across different racial and ethnic groups. FRAX is further limited by the exclusion of variables known to be associated with fracture risk, lack of dose-response relationships for variables, increased subsequent fracture risk after initial fracture, restriction to only one bone mineral density site, racial and ethnic differences that may influence fracture risk, and availability of racial and ethnic fracture risk data to be used in the FRAX calculator. Finally, the values obtained from FRAX should not take the place of good clinical judgment. © 2010 The Author(s).
引用
收藏
页码:192 / 197
页数:5
相关论文
共 60 条
[1]
Nguyen T.V., Center J.R., Eisman J.A., Osteoporosis: Underrated, underdiagnosed and undertreated, Med J Aust, 180, (2004)
[2]
Delmas P.D., Van Langerijt L.D., Watts N.B., Eastell R., Genant H., Grauer A., Cahall D.L., Underdiagnosis of vertebral fractures is a worldwide problem: The IMPACT study, Journal of Bone and Mineral Research, 20, 4, pp. 557-563, (2005)
[3]
Vestergaard P., Rejnmark L., Mosekilde L., Osteoporosis is markedly underdiagnosed: A nationwide study from Denmark, Osteoporosis International, 16, 2, pp. 134-141, (2005)
[4]
Iba K., Takada J., Hatakeyama N., Kaya M., Isogai S., Tsuda H., Obata H., Miyano S., Yamashita T., Underutilization of antiosteoporotic drugs by orthopedic surgeons for prevention of a secondary osteoporotic fracture, Journal of Orthopaedic Science, 11, 5, pp. 446-449, (2006)
[5]
Siris E.S., Chen Y.-T., Abbott T.A., Barrett-Connor E., Miller P.D., Wehren L.E., Berger M.L., Bone mineral density thresholds for pharmacological intervention to prevent fractures, Archives of Internal Medicine, 164, 10, pp. 1108-1112, (2004)
[6]
Wainwright S.A., Marshall L.M., Ensrud K.E., Cauley J.A., Black D.M., Hillier T.A., Hochberg M.C., Vogt M.T., Orwoll E.S., Hip fracture in women without osteoporosis, Journal of Clinical Endocrinology and Metabolism, 90, 5, pp. 2787-2793, (2005)
[7]
Van Der Klift M., De Laet C.E.D.H., McCloskey E.V., Johnell O., Kanis J.A., Hofman A., Pols H.A.P., Risk factors for incident vertebral fractures in men and women: The rotterdam study, Journal of Bone and Mineral Research, 19, 7, pp. 1172-1180, (2004)
[8]
Sornay-Rendu E., Munoz F., Garnero P., Duboeuf F., Delmas P.D., Identification of osteopenic women at high risk of fracture: The OFELY study, Journal of Bone and Mineral Research, 20, 10, pp. 1813-1819, (2005)
[9]
Kanis J.A., Johnell O., Oden A., Dawson A., De Laet C., Jonsson B., Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds, Osteoporosis International, 12, 12, pp. 989-995, (2001)
[10]
Kanis J.A., Johnell O., De Laet C., Johansson H., Oden A., Delmas P., Eisman J., Fujiwara S., Garnero P., Kroger H., McCloskey E.V., Mellstrom D., Melton L.J., Pols H., Reeve J., Silman A., Tenenhouse A., A meta-analysis of previous fracture and subsequent fracture risk, Bone, 35, 2, pp. 375-382, (2004)