Rationale of the Spanish FRAX model in decision-making for predicting osteoporotic fractures: an update of FRIDEX cohort of Spanish women

Azagra, Rafael; Zwart, Marta; Encabo, Gloria; Aguyé, Amada; Martin-Sánchez, Juan Carlos; Puchol-Ruiz, Nuria; Gabriel-Escoda, Paula; Ortiz-Alinque, Sergio; Gené, Emilio; Iglesias, Milagros; Moriña, David; Diaz-Herrera, Miguel Angel; Utzet Sadurní, Mireia; Manresa, Josep Maria; GROIMAP study group

Rationale of the Spanish FRAX model in decision-making for predicting osteoporotic fractures: an update of FRIDEX cohort of Spanish women

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dc.contributor.author Azagra, Rafaelca
dc.contributor.author Zwart, Martaca
dc.contributor.author Encabo, Gloriaca
dc.contributor.author Aguyé, Amadaca
dc.contributor.author Martin-Sánchez, Juan Carlosca
dc.contributor.author Puchol-Ruiz, Nuriaca
dc.contributor.author Gabriel-Escoda, Paulaca
dc.contributor.author Ortiz-Alinque, Sergioca
dc.contributor.author Gené, Emilioca
dc.contributor.author Iglesias, Milagrosca
dc.contributor.author Moriña, Davidca
dc.contributor.author Diaz-Herrera, Miguel Angelca
dc.contributor.author Utzet Sadurní, Mireiaca
dc.contributor.author Manresa, Josep Mariaca
dc.contributor.author GROIMAP study groupca
dc.date.accessioned 2016-11-25T12:27:15Z
dc.date.available 2016-11-25T12:27:15Z
dc.date.issued 2016ca
dc.description.abstract Background: The FRAX® tool estimates the risk of a fragility fracture among the population and many countries have been evaluating its performance among their populations since its creation in 2007. The purpose of this study is to update the first FRIDEX cohort analysis comparing FRAX with the bone mineral density (BMD) model, and its predictive abilities. Methods: The discriminatory ability of the FRAX was assessed using the ‘area under curve’ of the receiver operating characteristic (AUC-ROC). Predictive ability was assessed by comparing estimated risk fractures with incidence fractures after a 10-year follow up period. Results: One thousand three hundred eight women ≥ 40 and ≤ 90 years followed up during a 10-year period. The AUC for major osteoporotic fractures using FRAX without DXA was 0.686 (95 % CI 0.630–0.742) and using FN T-score of DXA 0.714 (95 % CI 0.661–0.767). Using only the traditional parameters of DXA (FN T-score), the AUC was 0.706 (95 % CI 0.652–0.760). The AUC for hip osteoporotic fracture was 0.883 (95 % CI 0.827–0.938), 0.857 (95 % CI 0.773–0.941), and 0.814 (95 % CI 0.712–0.916) respectively. For major osteoporotic fractures, the overall predictive value using the ratio Observed fractures/Expected fractures calculated with FRAX without T-score of DXA was 2.29 and for hip fractures 2.28 and with the inclusion of the T-score 2.01 and 1.83 respectively. However, for hip fracture in women < 65 years was 1.53 and 1.24 respectively. Conclusions: The FRAX tool has been found to show a good discriminatory capacity for detecting women at high risk of fragility fracture, and is better for hip fracture than major fracture. The test of sensibility shows that it is, at least, not inferior than when using BMD model alone. The predictive capacity of FRAX tool needs some adjustment. This capacity is better for hip fracture prediction and better for women < 65 years. Further studies in Catalonia and other regions of Spain are needed to fine tune the FRAX tool’s predictive capability.
dc.description.sponsorship This study was supported in part by a research grants from: FEDER (European Union), Instituto de Salud Carlos III, Ministry of Economy and Competitivity and the Institut Universitari d’ Investigació en Atenció Primària IDIAP Jordi Gol. Barcelona. Spain. [registries n°:01133, 4464] and Cátedra UAB-Novartis 2009 Scholarship.
dc.format.mimetype application/pdfca
dc.identifier.citation Azagra R, Zwart M, Encabo M, Aguyé A, Martin-Sánchez JC, Puchol-Ruiz N, Gabriel-Escoda P, Ortiz-Alinque S, Gené E, Iglesias M, Moriña D, Diaz-Herrera MA, Utzet M, Manresa JM, GROIMAP study group. Rationale of the Spanish FRAX model in decision-making for predicting osteoporotic fractures: an update of FRIDEX cohort of Spanish women. BMC Musculoskeletal Disorders. 2016; 17:262. DOI: 10.1186/s12891-016-1096-6ca
dc.identifier.doi http://dx.doi.org/10.1186/s12891-016-1096-6
dc.identifier.issn 1471-2474ca
dc.identifier.uri http://hdl.handle.net/10230/27608
dc.language.iso engca
dc.publisher BioMed Centralca
dc.relation.ispartof BMC Musculoskeletal Disorders. 2016; 17:262
dc.rights © 2016 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.or /licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.ca
dc.rights.accessRights info:eu-repo/semantics/openAccessca
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.keyword Osteoporosis
dc.subject.keyword Fracture
dc.subject.keyword FRAX
dc.subject.keyword FRIDEX
dc.subject.keyword Study cohort
dc.subject.keyword Algorithm
dc.title Rationale of the Spanish FRAX model in decision-making for predicting osteoporotic fractures: an update of FRIDEX cohort of Spanish womenca
dc.type info:eu-repo/semantics/articleca
dc.type.version info:eu-repo/semantics/publishedVersionca

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