R Azagra1, M Zwart2, A Aguyé3, J C Martín-Sánchez4, E Casado5, M A Díaz-Herrera6, D Moriña7, C Cooper8, A Díez-Pérez9, E M Dennison10. 1. Department of Medicine, Universitat Autònoma de Barcelona, ps/Vall d' Hebron 119, 08135 Barcelona, Spain; Health Center Badia del Valles (ICS), GROIMAP-USR MN-IDIAP Jordi Gol, c/Bética s/n, 08214 Badia del Vallés Barcelona, Spain; Idc-Hospital General de Catalunya, Universitat Internacional de Catalunya, c/Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain. Electronic address: rafael.azagra@uab.cat. 2. Department of Medicine, Universitat Autònoma de Barcelona, ps/Vall d' Hebron 119, 08135 Barcelona, Spain; Health Center Can Gibert del Plà (ICS), USR Girona-IDIAP Jordi Gol, c/San Sebastian 9, 17005 Girona, Spain. 3. Department of Medicine, Universitat Autònoma de Barcelona, ps/Vall d' Hebron 119, 08135 Barcelona, Spain; Health Center Granollers Valles Oriental (ICS), GROIMAP-USR MN-IDIAP Jordi Gol, c/Museu 19, 08400 Granollers, Barcelona, Spain. 4. Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, c/Josep Trueta s/n, 08195 Sant Cugat del Valles, Barcelona, Spain. 5. Rheumatology Department, Hospital de Sabadell, Consorci Sanitari Parc Taulí, Universitat Autònoma de Barcelona. Parc Tauli s/n, 08208 Sabadell, Spain. 6. Health Center Cornellà-2 (Sant Ildefons), c/República Argentina s/n, 08940 Cornellá, Barcelona, Spain. 7. Department of Medicine, Universitat Autònoma de Barcelona, ps/Vall d' Hebron 119, 08135 Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública (CIBERESP), Unitat de Fonaments de l'Anàlisi Econòmica, Departament d'Economia i Història Econòmica, Universitat Autònoma de Barcelona, c/Dr. Aiguader 88, 08003 Barcelona, Spain. 8. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK. 9. Department of Medicine, Universitat Autònoma de Barcelona, ps/Vall d' Hebron 119, 08135 Barcelona, Spain; Department of Internal Medicine, URFOA, IMIM, Parc de Salut Mar, Ps Maritimo 25-29, 08003 Barcelona, Spain; Red Temática de Envejecimiento y Fragilidad RETICEF, Instituto de Salud Carlos III-FEDER, Madrid, Spain. 10. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Victoria University, PO Box 600, Wellington 6140, New Zealand.
Abstract
OBJECTIVE: To perform an external validation of FRAX algorithm thresholds for reporting level of risk of fracture in Spanish women (low < 5%; intermediate ≥ 5% and < 7.5%; high ≥ 7.5%) taken from a prospective cohort "FRIDEX". METHODS: A retrospective study of 1090 women aged ≥ 40 and ≤ 90 years old obtained from the general population (FROCAT cohort). FRAX was calculated with data registered in 2002. All fractures were validated in 2012. Sensitivity analysis was performed. RESULTS: When analyzing the cohort (884) excluding current or past anti osteoporotic medication (AOM), using our nominated thresholds, among the 621 (70.2%) women at low risk of fracture, 5.2% [CI95%: 3.4-7.6] sustained a fragility fracture; among the 99 at intermediate risk, 12.1% [6.4-20.2]; and among the 164 defined as high risk, 15.9% [10.6-24.2]. Sensitivity analysis against model risk stratification FRIDEX of FRAX Spain shows no significant difference. By including 206 women with AOM, the sensitivity analysis shows no difference in the group of intermediate and high risk and minimal differences in the low risk group. CONCLUSIONS: Our findings support and validate the use of FRIDEX thresholds of FRAX when discussing the risk of fracture and the initiation of therapy with patients.
OBJECTIVE: To perform an external validation of FRAX algorithm thresholds for reporting level of risk of fracture in Spanish women (low < 5%; intermediate ≥ 5% and < 7.5%; high ≥ 7.5%) taken from a prospective cohort "FRIDEX". METHODS: A retrospective study of 1090 women aged ≥ 40 and ≤ 90 years old obtained from the general population (FROCAT cohort). FRAX was calculated with data registered in 2002. All fractures were validated in 2012. Sensitivity analysis was performed. RESULTS: When analyzing the cohort (884) excluding current or past anti osteoporotic medication (AOM), using our nominated thresholds, among the 621 (70.2%) women at low risk of fracture, 5.2% [CI95%: 3.4-7.6] sustained a fragility fracture; among the 99 at intermediate risk, 12.1% [6.4-20.2]; and among the 164 defined as high risk, 15.9% [10.6-24.2]. Sensitivity analysis against model risk stratification FRIDEX of FRAX Spain shows no significant difference. By including 206 women with AOM, the sensitivity analysis shows no difference in the group of intermediate and high risk and minimal differences in the low risk group. CONCLUSIONS: Our findings support and validate the use of FRIDEX thresholds of FRAX when discussing the risk of fracture and the initiation of therapy with patients.
Authors: L Vandenput; H Johansson; E V McCloskey; E Liu; K E Åkesson; F A Anderson; R Azagra; C L Bager; C Beaudart; H A Bischoff-Ferrari; E Biver; O Bruyère; J A Cauley; J R Center; R Chapurlat; C Christiansen; C Cooper; C J Crandall; S R Cummings; J A P da Silva; B Dawson-Hughes; A Diez-Perez; A B Dufour; J A Eisman; P J M Elders; S Ferrari; Y Fujita; S Fujiwara; C-C Glüer; I Goldshtein; D Goltzman; V Gudnason; J Hall; D Hans; M Hoff; R J Hollick; M Huisman; M Iki; S Ish-Shalom; G Jones; M K Karlsson; S Khosla; D P Kiel; W-P Koh; F Koromani; M A Kotowicz; H Kröger; T Kwok; O Lamy; A Langhammer; B Larijani; K Lippuner; D Mellström; T Merlijn; A Nordström; P Nordström; T W O'Neill; B Obermayer-Pietsch; C Ohlsson; E S Orwoll; J A Pasco; F Rivadeneira; B Schei; A-M Schott; E J Shiroma; K Siggeirsdottir; E M Simonsick; E Sornay-Rendu; R Sund; K M A Swart; P Szulc; J Tamaki; D J Torgerson; N M van Schoor; T P van Staa; J Vila; N J Wareham; N C Wright; N Yoshimura; M C Zillikens; M Zwart; N C Harvey; M Lorentzon; W D Leslie; J A Kanis Journal: Osteoporos Int Date: 2022-05-31 Impact factor: 5.071
Authors: Jonatan Miguel-Carrera; Carlos García-Porrua; Francisco Javier de Toro Santos; Jose Antonio Picallo-Sánchez Journal: Aten Primaria Date: 2017-06-17 Impact factor: 1.137
Authors: Fernando Guerrero-Pérez; Anna Casajoana; Carmen Gómez-Vaquero; Nuria Virgili; Rafael López-Urdiales; Laura Hernández-Montoliu; Jordi Pujol-Gebelli; Javier Osorio; Anna Prats; Anna Vidal-Alabró; Manuel Pérez-Maraver; Sonia Fernández-Veledo; Joan Vendrell; Nuria Vilarrasa Journal: J Clin Med Date: 2020-06-11 Impact factor: 4.241