Osteoporosis International

, 22:2395

Interpretation and use of FRAX in clinical practice

  • J. A. Kanis
  • D. Hans
  • C. Cooper
  • S. Baim
  • J. P. Bilezikian
  • N. Binkley
  • J. A. Cauley
  • J. E. Compston
  • B. Dawson-Hughes
  • G. El-Hajj Fuleihan
  • H. Johansson
  • W. D. Leslie
  • E. M. Lewiecki
  • M. Luckey
  • A. Oden
  • S. E. Papapoulos
  • C. Poiana
  • R. Rizzoli
  • D. A. Wahl
  • E. V. McCloskey
  • Task Force of the FRAX Initiative
Position Paper

DOI: 10.1007/s00198-011-1713-z

Cite this article as:
Kanis, J.A., Hans, D., Cooper, C. et al. Osteoporos Int (2011) 22: 2395. doi:10.1007/s00198-011-1713-z

Abstract

Summary

The introduction of the WHO FRAX® algorithms has facilitated the assessment of fracture risk on the basis of fracture probability. Its use in fracture risk prediction has strengths, but also limitations of which the clinician should be aware and are the focus of this review

Introduction

The International Osteoporosis Foundation (IOF) and the International Society for Clinical Densitometry (ISCD) appointed a joint Task Force to develop resource documents in order to make recommendations on how to improve FRAX and better inform clinicians who use FRAX. The Task Force met in November 2010 for 3 days to discuss these topics which form the focus of this review.

Methods

This study reviews the resource documents and joint position statements of ISCD and IOF.

Results

Details on the clinical risk factors currently used in FRAX are provided, and the reasons for the exclusion of others are provided. Recommendations are made for the development of surrogate models where country-specific FRAX models are not available.

Conclusions

The wish list of clinicians for the modulation of FRAX is large, but in many instances, these wishes cannot presently be fulfilled; however, an explanation and understanding of the reasons may be helpful in translating the information provided by FRAX into clinical practice.

Keywords

Bone mineral densityClinical risk factorsFracture probabilityRisk assessment

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • J. A. Kanis
    • 1
  • D. Hans
    • 2
  • C. Cooper
    • 3
    • 4
  • S. Baim
    • 5
  • J. P. Bilezikian
    • 6
  • N. Binkley
    • 7
  • J. A. Cauley
    • 8
  • J. E. Compston
    • 9
  • B. Dawson-Hughes
    • 10
  • G. El-Hajj Fuleihan
    • 11
  • H. Johansson
    • 12
  • W. D. Leslie
    • 13
  • E. M. Lewiecki
    • 14
  • M. Luckey
    • 15
  • A. Oden
    • 12
  • S. E. Papapoulos
    • 16
  • C. Poiana
    • 17
  • R. Rizzoli
    • 18
  • D. A. Wahl
    • 19
  • E. V. McCloskey
    • 20
  • Task Force of the FRAX Initiative
  1. 1.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  2. 2.Center of Bone Diseases, Bone and Joint DepartmentLausanne University HospitalLausanneSwitzerland
  3. 3.MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
  4. 4.NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal SciencesUniversity of OxfordOxfordUK
  5. 5.Division of EndocrinologyUniversity of Miami, Miller School of MedicineCoral GablesUSA
  6. 6.Columbia University College of Physicians and SurgeonsNew YorkUSA
  7. 7.Osteoporosis Clinical Research ProgramUniversity of WisconsinMadisonUSA
  8. 8.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  9. 9.Department of Medicine, Addenbrooke’s HospitalCambridge UniversityCambridgeUK
  10. 10.Jean Mayer United States Department of Agriculture Human Nutrition Research Center on AgingTufts UniversityBostonUSA
  11. 11.WHO Collaborating Center for Metabolic Bone DisordersAmerican University of BeirutBeirutLebanon
  12. 12.Centre for Bone Research at the Sahlgrenska Academy, Institute of MedicineUniversity of GothenburgGothenburgSweden
  13. 13.University of ManitobaWinnipegCanada
  14. 14.New Mexico Clinical Research & Osteoporosis CenterUniversity of New Mexico School of MedicineAlbuquerqueUSA
  15. 15.St. Barnabas Osteoporosis & Metabolic Bone Disease CenterLivingstonUSA
  16. 16.Department of Endocrinology and Metabolic DiseasesLeiden University Medical CenterLeidenthe Netherlands
  17. 17.Department of EndocrinologyCarol Davila University of Medicine and PharmacyBucharestRomania
  18. 18.Division of Bone Diseases, Department of Rehabilitation and GeriatricsGeneva University Hospitals and Faculty of MedicineGenevaSwitzerland
  19. 19.International Osteoporosis FoundationNyonSwitzerland
  20. 20.Academic Unit of Bone MetabolismUniversity of SheffieldSheffieldUK