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New IOF-ISCD review clarifies the use of FRAX in clinical practice
Date:8/2/2011

re based on country-specific data. Unlike more simple risk models, the tool integrates mortality as well as age-specific fracture rate statistics. -FRAX is appreciated for its simplicity for use in primary care. It is primarily used as a clinical tool to help physicians assess fracture probability as an aid in identifying which individuals may be candidates for reassurance, bone density evaluation or pharmacological treatment. FRAX is also used for guideline development, drug registration and health economic applications. -The tool is freely accessible online. As well, it is available via iPhone, as a hand held calculator, and is integrated in densitometry technology. It is available in 16 languages and a growing number of country models (currently 40 models for 34 countries).

Limitations: -FRAX does not take into account all risk variables of which the physician should be aware. These include, for example, the risks associated with falls, markers of bone turnover levels, other bone density assessments, as well as certain secondary causes of osteoporosis. -For most clinical risk factors, FRAX uses yes/no answers and the average risk is computed. It therefore does not take into account the variation of risks associated with high or low doses of glucocorticoids, the number and type of prior fractures, or the quantity of alcohol or tobacco consumption. -Other limitations of FRAX are dictated by the current scientific evidence available. FRAX does not take into consideration patients on treatment, younger men and women, variations of fracture rates within countries and changes of country-specific fracture rates over time.

In countries not yet included in FRAX, physicians may use surrogate country models, preferably choosing a surrogate model country which best approximates the fracture risk and death hazard of the index country.

Professor Cyrus Cooper, chair of the IOF Committee of Scientific Advisors and co-chair o
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Contact: L. Misteli
info@iofbonehealth.org
41-229-940-100
International Osteoporosis Foundation
Source:Eurekalert

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