Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX
Summary Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk e...
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| Veröffentlicht in: | Archives of osteoporosis 2023-03, Vol.18 (1), p.43-43, Article 43 |
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| creator | Yang, Lan Dempsey, Mary Brennan, Attracta Whelan, Bryan Erjiang, E. Wang, Tingyan Egan, Rebecca Gorham, Kelly Heaney, Fiona Armstrong, Catherine Ibarrola, Guadalupe Morote Gsel, Amina Yu, Ming Carey, John J. |
| description | Summary
Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients.
Purpose
FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD.
Method
A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland–Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results.
Results
Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9%
vs
. 2.8% and 11.0%
vs
. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively,
P
|
| doi_str_mv | 10.1007/s11657-023-01232-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10027809</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2788800651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c398t-463a64e426387d8456abfbebe31c3d89ae316de112cb250bd9c4481d4960310e3</originalsourceid><addsrcrecordid>eNp9kV1LwzAUhoMobk7_gBfSS2-q-WjT9ErGdHMwEERxdyFp0pnRj5m0Qv-92TrHvPEqJznPeU94XwCuEbxDECb3DiEaJyHEJIQIExx2J2CIGMUhiVF0elQPwIVzawgpRDE9BwNCU5KmJBmC2dzqQlQqeFyOw-nreBmUoguUyXNtA2dWlclNJqqm6IIt5VrpGn81ovAvTR18aLkbuwRnuSicvtqfI_A-fXqbPIeLl9l8Ml6EGUlZE0aUCBrpCFPCEsWimAqZSy01QRlRLBW-oEojhDOJYyhVmkURQypKKSQIajICD73uppWlVpmuGisKvrGmFLbjtTD8b6cyn3xVf3PvGE4YTL3C7V7B1l-tdg0vjct04V3Qdeu4pxjzVsXIo7hHM1s7Z3V-2IPgVjDhfQTcR8B3EfDOD90c__Aw8uu5B0gPON-qVtrydd3ayrv2n-wPhw-R1w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2788800651</pqid></control><display><type>article</type><title>Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Yang, Lan ; Dempsey, Mary ; Brennan, Attracta ; Whelan, Bryan ; Erjiang, E. ; Wang, Tingyan ; Egan, Rebecca ; Gorham, Kelly ; Heaney, Fiona ; Armstrong, Catherine ; Ibarrola, Guadalupe Morote ; Gsel, Amina ; Yu, Ming ; Carey, John J.</creator><creatorcontrib>Yang, Lan ; Dempsey, Mary ; Brennan, Attracta ; Whelan, Bryan ; Erjiang, E. ; Wang, Tingyan ; Egan, Rebecca ; Gorham, Kelly ; Heaney, Fiona ; Armstrong, Catherine ; Ibarrola, Guadalupe Morote ; Gsel, Amina ; Yu, Ming ; Carey, John J. ; DXA MAP Group ; the DXA MAP Group</creatorcontrib><description>Summary
Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients.
Purpose
FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD.
Method
A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland–Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results.
Results
Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9%
vs
. 2.8% and 11.0%
vs
. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively,
P
< 0.001. Within-subject differences between hip fracture estimates with and without BMD were < 3% in 57% of cases, between 3 and 6% in 19% of cases, and > 6% in 24% of cases, while for major osteoporotic fractures such differences are < 10% in 82% of cases, between 10 and 20% in 15% of cases, and > 20% in 3% of cases.
Conclusions
Although there is excellent agreement between the Web-FRAX and DXA-FRAX tools when BMD is incorporated, sometimes there are very large differences for individuals between results obtained with and without BMD. Clinicians should carefully consider the importance of BMD inclusion in FRAX estimations when assessing individual patients.</description><identifier>ISSN: 1862-3514</identifier><identifier>ISSN: 1862-3522</identifier><identifier>EISSN: 1862-3514</identifier><identifier>DOI: 10.1007/s11657-023-01232-y</identifier><identifier>PMID: 36939937</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Absorptiometry, Photon ; Adult ; Aged ; Aged, 80 and over ; Bone Density ; Cross-Sectional Studies ; Endocrinology ; Female ; Humans ; Ireland ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original ; Original Article ; Orthopedics ; Osteoporotic Fractures - diagnostic imaging ; Osteoporotic Fractures - epidemiology ; Risk Assessment - methods ; Risk Factors</subject><ispartof>Archives of osteoporosis, 2023-03, Vol.18 (1), p.43-43, Article 43</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c398t-463a64e426387d8456abfbebe31c3d89ae316de112cb250bd9c4481d4960310e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11657-023-01232-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11657-023-01232-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36939937$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Lan</creatorcontrib><creatorcontrib>Dempsey, Mary</creatorcontrib><creatorcontrib>Brennan, Attracta</creatorcontrib><creatorcontrib>Whelan, Bryan</creatorcontrib><creatorcontrib>Erjiang, E.</creatorcontrib><creatorcontrib>Wang, Tingyan</creatorcontrib><creatorcontrib>Egan, Rebecca</creatorcontrib><creatorcontrib>Gorham, Kelly</creatorcontrib><creatorcontrib>Heaney, Fiona</creatorcontrib><creatorcontrib>Armstrong, Catherine</creatorcontrib><creatorcontrib>Ibarrola, Guadalupe Morote</creatorcontrib><creatorcontrib>Gsel, Amina</creatorcontrib><creatorcontrib>Yu, Ming</creatorcontrib><creatorcontrib>Carey, John J.</creatorcontrib><creatorcontrib>DXA MAP Group</creatorcontrib><creatorcontrib>the DXA MAP Group</creatorcontrib><title>Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX</title><title>Archives of osteoporosis</title><addtitle>Arch Osteoporos</addtitle><addtitle>Arch Osteoporos</addtitle><description>Summary
Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients.
Purpose
FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD.
Method
A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland–Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results.
Results
Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9%
vs
. 2.8% and 11.0%
vs
. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively,
P
< 0.001. Within-subject differences between hip fracture estimates with and without BMD were < 3% in 57% of cases, between 3 and 6% in 19% of cases, and > 6% in 24% of cases, while for major osteoporotic fractures such differences are < 10% in 82% of cases, between 10 and 20% in 15% of cases, and > 20% in 3% of cases.
Conclusions
Although there is excellent agreement between the Web-FRAX and DXA-FRAX tools when BMD is incorporated, sometimes there are very large differences for individuals between results obtained with and without BMD. Clinicians should carefully consider the importance of BMD inclusion in FRAX estimations when assessing individual patients.</description><subject>Absorptiometry, Photon</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bone Density</subject><subject>Cross-Sectional Studies</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Humans</subject><subject>Ireland</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporotic Fractures - diagnostic imaging</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><issn>1862-3514</issn><issn>1862-3522</issn><issn>1862-3514</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kV1LwzAUhoMobk7_gBfSS2-q-WjT9ErGdHMwEERxdyFp0pnRj5m0Qv-92TrHvPEqJznPeU94XwCuEbxDECb3DiEaJyHEJIQIExx2J2CIGMUhiVF0elQPwIVzawgpRDE9BwNCU5KmJBmC2dzqQlQqeFyOw-nreBmUoguUyXNtA2dWlclNJqqm6IIt5VrpGn81ovAvTR18aLkbuwRnuSicvtqfI_A-fXqbPIeLl9l8Ml6EGUlZE0aUCBrpCFPCEsWimAqZSy01QRlRLBW-oEojhDOJYyhVmkURQypKKSQIajICD73uppWlVpmuGisKvrGmFLbjtTD8b6cyn3xVf3PvGE4YTL3C7V7B1l-tdg0vjct04V3Qdeu4pxjzVsXIo7hHM1s7Z3V-2IPgVjDhfQTcR8B3EfDOD90c__Aw8uu5B0gPON-qVtrydd3ayrv2n-wPhw-R1w</recordid><startdate>20230320</startdate><enddate>20230320</enddate><creator>Yang, Lan</creator><creator>Dempsey, Mary</creator><creator>Brennan, Attracta</creator><creator>Whelan, Bryan</creator><creator>Erjiang, E.</creator><creator>Wang, Tingyan</creator><creator>Egan, Rebecca</creator><creator>Gorham, Kelly</creator><creator>Heaney, Fiona</creator><creator>Armstrong, Catherine</creator><creator>Ibarrola, Guadalupe Morote</creator><creator>Gsel, Amina</creator><creator>Yu, Ming</creator><creator>Carey, John J.</creator><general>Springer London</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230320</creationdate><title>Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX</title><author>Yang, Lan ; Dempsey, Mary ; Brennan, Attracta ; Whelan, Bryan ; Erjiang, E. ; Wang, Tingyan ; Egan, Rebecca ; Gorham, Kelly ; Heaney, Fiona ; Armstrong, Catherine ; Ibarrola, Guadalupe Morote ; Gsel, Amina ; Yu, Ming ; Carey, John J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-463a64e426387d8456abfbebe31c3d89ae316de112cb250bd9c4481d4960310e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Absorptiometry, Photon</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bone Density</topic><topic>Cross-Sectional Studies</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Humans</topic><topic>Ireland</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporotic Fractures - diagnostic imaging</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Lan</creatorcontrib><creatorcontrib>Dempsey, Mary</creatorcontrib><creatorcontrib>Brennan, Attracta</creatorcontrib><creatorcontrib>Whelan, Bryan</creatorcontrib><creatorcontrib>Erjiang, E.</creatorcontrib><creatorcontrib>Wang, Tingyan</creatorcontrib><creatorcontrib>Egan, Rebecca</creatorcontrib><creatorcontrib>Gorham, Kelly</creatorcontrib><creatorcontrib>Heaney, Fiona</creatorcontrib><creatorcontrib>Armstrong, Catherine</creatorcontrib><creatorcontrib>Ibarrola, Guadalupe Morote</creatorcontrib><creatorcontrib>Gsel, Amina</creatorcontrib><creatorcontrib>Yu, Ming</creatorcontrib><creatorcontrib>Carey, John J.</creatorcontrib><creatorcontrib>DXA MAP Group</creatorcontrib><creatorcontrib>the DXA MAP Group</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of osteoporosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Lan</au><au>Dempsey, Mary</au><au>Brennan, Attracta</au><au>Whelan, Bryan</au><au>Erjiang, E.</au><au>Wang, Tingyan</au><au>Egan, Rebecca</au><au>Gorham, Kelly</au><au>Heaney, Fiona</au><au>Armstrong, Catherine</au><au>Ibarrola, Guadalupe Morote</au><au>Gsel, Amina</au><au>Yu, Ming</au><au>Carey, John J.</au><aucorp>DXA MAP Group</aucorp><aucorp>the DXA MAP Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX</atitle><jtitle>Archives of osteoporosis</jtitle><stitle>Arch Osteoporos</stitle><addtitle>Arch Osteoporos</addtitle><date>2023-03-20</date><risdate>2023</risdate><volume>18</volume><issue>1</issue><spage>43</spage><epage>43</epage><pages>43-43</pages><artnum>43</artnum><issn>1862-3514</issn><issn>1862-3522</issn><eissn>1862-3514</eissn><abstract>Summary
Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients.
Purpose
FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD.
Method
A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland–Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results.
Results
Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9%
vs
. 2.8% and 11.0%
vs
. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively,
P
< 0.001. Within-subject differences between hip fracture estimates with and without BMD were < 3% in 57% of cases, between 3 and 6% in 19% of cases, and > 6% in 24% of cases, while for major osteoporotic fractures such differences are < 10% in 82% of cases, between 10 and 20% in 15% of cases, and > 20% in 3% of cases.
Conclusions
Although there is excellent agreement between the Web-FRAX and DXA-FRAX tools when BMD is incorporated, sometimes there are very large differences for individuals between results obtained with and without BMD. Clinicians should carefully consider the importance of BMD inclusion in FRAX estimations when assessing individual patients.</abstract><cop>London</cop><pub>Springer London</pub><pmid>36939937</pmid><doi>10.1007/s11657-023-01232-y</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1862-3514 |
| ispartof | Archives of osteoporosis, 2023-03, Vol.18 (1), p.43-43, Article 43 |
| issn | 1862-3514 1862-3522 1862-3514 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Absorptiometry, Photon Adult Aged Aged, 80 and over Bone Density Cross-Sectional Studies Endocrinology Female Humans Ireland Male Medicine Medicine & Public Health Middle Aged Original Original Article Orthopedics Osteoporotic Fractures - diagnostic imaging Osteoporotic Fractures - epidemiology Risk Assessment - methods Risk Factors |
| title | Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX |
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