UNLABELLED: A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. INTRODUCTION: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). METHODS: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N = 4,778) and men (N = 1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. RESULTS: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. CONCLUSION: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.
UNLABELLED: A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. INTRODUCTION: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). METHODS: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N = 4,778) and men (N = 1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. RESULTS: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. CONCLUSION: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.
Authors: J D Adachi; G Loannidis; C Berger; L Joseph; A Papaioannou; L Pickard; E A Papadimitropoulos; W Hopman; S Poliquin; J C Prior; D A Hanley; W P Olszynski; T Anastassiades; J P Brown; T Murray; S A Jackson; A Tenenhouse Journal: Osteoporos Int Date: 2001 Impact factor: 4.507
Authors: John A Kanis; Olof Johnell; Chris De Laet; Bengt Jonsson; Anders Oden; Alan K Ogelsby Journal: J Bone Miner Res Date: 2002-07 Impact factor: 6.741
Authors: Ethel S Siris; Ya-Ting Chen; Thomas A Abbott; Elizabeth Barrett-Connor; Paul D Miller; Lois E Wehren; Marc L Berger Journal: Arch Intern Med Date: 2004-05-24
Authors: Claudie Berger; David Goltzman; Lisa Langsetmo; Lawrence Joseph; Stuart Jackson; Nancy Kreiger; Alan Tenenhouse; K Shawn Davison; Robert G Josse; Jerilynn C Prior; David A Hanley Journal: J Bone Miner Res Date: 2010-09 Impact factor: 6.741
Authors: Lisa Langsetmo; David Goltzman; Christopher S Kovacs; Jonathan D Adachi; David A Hanley; Nancy Kreiger; Robert Josse; Alexandra Papaioannou; Wojciech P Olszynski; Sophie A Jamal Journal: J Bone Miner Res Date: 2009-09 Impact factor: 6.741
Authors: J A Kanis; H Johansson; A Oden; O Johnell; C De Laet; J A Eisman; E V McCloskey; D Mellstrom; L J Melton; H A P Pols; J Reeve; A J Silman; A Tenenhouse Journal: Bone Date: 2004-11 Impact factor: 4.398
Authors: Alexandra Papaioannou; Suzanne Morin; Angela M Cheung; Stephanie Atkinson; Jacques P Brown; Sidney Feldman; David A Hanley; Anthony Hodsman; Sophie A Jamal; Stephanie M Kaiser; Brent Kvern; Kerry Siminoski; William D Leslie Journal: CMAJ Date: 2010-10-12 Impact factor: 8.262
Authors: Melissa Premaor; Richard A Parker; Steve Cummings; Kris Ensrud; Jane A Cauley; Li-Yung Lui; Theresa Hillier; Juliet Compston Journal: J Bone Miner Res Date: 2013-01 Impact factor: 6.741
Authors: William D Leslie; Helena Johansson; Eugene V McCloskey; Nicholas C Harvey; John A Kanis; Didier Hans Journal: J Bone Miner Res Date: 2018-07-16 Impact factor: 6.741
Authors: W D Leslie; E Shevroja; H Johansson; E V McCloskey; N C Harvey; J A Kanis; D Hans Journal: Osteoporos Int Date: 2018-02-01 Impact factor: 4.507
Authors: W D Leslie; S N Morin; L M Lix; P Martineau; M Bryanton; E V McCloskey; H Johansson; N C Harvey; J A Kanis Journal: Osteoporos Int Date: 2019-08-02 Impact factor: 4.507