Clinicians in an increasing number of countries can now take advantage of an important new online tool for the clinical management of osteoporosis.
FRAX, which is freely available for use online, was launched in February 2008. It was developed by Professor John A. Kanis and colleagues from the WHO Collaborating Centre for Metabolic Bone Diseases at the University of Sheffield Medical School in the UK and is underpinned by the WHO Technical Report entitled "Assessment of Osteoporosis at Primary Health Care Level". The tool assesses the ten-year risk (absolute risk) of fracture of an individual, based on his/her clinical risk factors, which include an individual's age, sex, weight, height, prior fracture, parental history of hip fracture, smoking, long-term use of glucocorticoids, rheumatoid arthritis and alcohol consumption. Although bone mineral density (BMD) is no longer the sole criteria used to determine fracture risk, BMD values can be input into the calculation to better refine the accuracy of the result.
The great potential advantage of the tool is a better allocation of healthcare resources towards patients at higher risk of fracture. All risk factors are weighted depending on their relative risk for fracture, with, for example, age and low BMD being higher risk factors compared to alcohol consumption. The online tool provides easy access for the evaluation of a patient's fracture risk (hip and other osteoporotic fractures) and is of particular importance in countries where densitometry scans are not necessarily available.
Professor Kanis commented, "The incorporation of the WHO Fracture Risk Assessment Tool into practice guidelines around the world will help improve patient management and avoid unnecessary treatment in men and women at low risk. I hope that the tool, which is freely available to all, will be adopted worldwide as the determination of fracture probability becomes more country-specific."
The tool, previously available for China, France, Italy, Japan, Spain, Sweden, Turkey, UK, and the USA is now extended for use in Austria, Germany and Switzerland. It is expected that FRAX will be available for several other countries before the end of the year. With some 55,000 hits per month, FRAX is becoming a widely used tool in the clinical setting.
The FRAX tool has been integrated into new clinical guidelines for the management of osteoporosis in the U.K. and in the U.S.A and has also been adopted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis in new guidelines issued in 2008.
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International Osteoporosis Foundation