Impact of UK National Guidelines based on FRAX®--comparison with current clinical practice

Clinical Endocrinology
N J CrabtreeNational Osteoporosis Guidelines Group

Abstract

To assess whether clinician-determined treatment intervention thresholds are in line with the assessment of fracture risk provided by FRAX® and treatment recommendations provided by UK guidelines produced by the National Osteoporosis Guidelines Group (NOGG). This was a retrospective cohort analysis of 288 patients consecutively referred for dual-energy X-ray absorptiometry (DXA) scanning from primary care immediately prior to the introduction of the FRAX® algorithm. In addition to DXA assessment, patients completed a clinical risk factor questionnaire which included risk factors used in the FRAX® algorithm. Initial risk assessment and treatment decisions were performed after DXA. FRAX® was used, retrospectively, with femoral neck T-score, to estimate fracture risk which was applied to NOGG to generate guidance on treatment intervention. Clinician- and NOGG-determined outcomes were audited for concordance. There was concordance between clinician and NOGG treatment decisions in 215 (74.6%) subjects. Discordance was observed in 73 (25.3%) subjects. In the discordant group, seven subjects were given lifestyle advice when NOGG recommended treatment, 42 given treatment when NOGG recommended lifestyle advice only, and 24 were referred...Continue Reading

Citations

Oct 18, 2011·BMC Medical Informatics and Decision Making·Emma WallaceUNKNOWN International Diagnostic and Prognosis Prediction (IDAPP) group
Jun 15, 2011·Gender Medicine·Qing WuJeanette H Magnus
Jul 18, 2018·Journal of Neurotrauma·Sarah B RockswoldChristophe Lenglet

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