Fracture Risk Assessment With FRAX Using Real-World Data in a Population-Based Cohort From Israel

American Journal of Epidemiology
Inbal GoldshteinMoshe Leshno

Abstract

The predictive value of the World Health Organization's Fracture Risk Assessment Tool (FRAX) was evaluated using real-world community data. A population-based cohort of 141,320 women aged 50-90 years (median age, 58 years; interquartile range, 54-67) in 2004 was extracted from the central database of a large Israeli health-care services provider and insurer. Retrospective FRAX scores were calculated using computerized health records and compared with actual incidence of major osteoporotic fractures (MOFs) during the following 10 years. Fracture proportions of 6.9% for MOFs and 2.2% for hip fractures were expected, as opposed to 13.5% and 2.9% observed. The area under the receiver operating characteristic curve (AUC) of FRAX scores calculated without the inclusion of bone mineral density (BMD) data was 0.65 (95% confidence interval: 0.65, 0.66) for MOF and 0.82 (95% confidence interval: 0.81, 0.82) for hip fracture. A total of 16,578 subjects had BMD data at the index date, and their risk estimates based solely on BMD exhibited lower predictive performance for both MOFs (AUC = 0.62 vs. 0.65; P = 0.003) and hip fractures (AUC = 0.78 vs. 0.84; P < 0.001) as compared with FRAX. FRAX scores based on electronic health records provide...Continue Reading

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Citations

Mar 5, 2018·Archives of Osteoporosis·Inbal GoldshteinVarda Shalev
Apr 24, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Michael MorkosLeon Fogelfeld
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Feb 16, 2021·Journal of Orthopaedic Trauma·Robert ZuraJohn I Mackowiak
Jul 29, 2021·Climacteric : the Journal of the International Menopause Society·E V McCloskeyJ A Kanis

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