Tufts researcher leads revision of osteoporosis ...( Tufts University researcher Bess Daw...),Health

Tufts University researcher Bess Dawson-Hughes, M.D., chaired the committee that recently updated the National Osteoporosis Foundation (NOF) Clinician's Guide to Prevention and Treatment of Osteoporosis. The new Clinician's Guide incorporates the World Health Organization (WHO) absolute fracture prediction algorithm (FRAX), a computer-based tool expected to increase the identification of patients at risk for osteoporosis.

"The introduction of the WHO's fracture prediction algorithm necessitated the revision of the Clinician's Guide," says Dawson-Hughes, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. "The algorithm tells clinicians how likely a patient is to fracture a bone due to osteoporosis or low bone mass in the 10 years following examination, also known as 10-year fracture risk. This can help clinicians decide whether a patient needs to be treated or simply monitored."

Writing in the April 2008 issue of the journal Osteoporosis International, corresponding author Dawson-Hughes and colleagues describe how to apply FRAX in the United States. Clinicians estimate a patient's 10-year fracture risk using a computer program that considers bone mineral density (BMD) score, or T-score, and nine clinical risk factors including personal fracture history, family fracture history, weight, race and gender. Notably, FRAX and the new Clinician's Guide now apply to men over 50 and post-menopausal non-Caucasian women, including African-Americans, Asians and Latinas. Previous versions applied only to post-menopausal Caucasian women, the group at highest-risk for osteoporosis.

In their analysis, Dawson-Hughes and colleagues highlight the inclusion of men in the guide. "Post menopausal women remain the most vulnerable to osteoporotic fractures, yet clinicians should not overlook men because their fracture risk may be lower," says Dawson-Hughes, who is also a professor
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