期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 9, 页码 -出版社
MDPI
DOI: 10.3390/jcm11092409
关键词
FRAX; validation; calibration; epidemiological methods; clinical decision-making; real-world data
资金
- Instituto de Salud Carlos III from the Spanish Ministry of Health [PS09/02500, PI11/00238, PI13/01721]
- European Regional Development Fund
- Valencia Department of Health and FISABIO, a non-profit research institution depending on the Valencia Dpt. of Health
- MSD Spain
- AMGEN S.A.
This study compared the performance of the fracture risk assessment tool (FRAX) and a simple age and sex model in a Spanish population. The results showed that the two models had virtually identical performance, suggesting that the simple model can provide comparable predictive ability to FRAX.
In Spain, the Fracture Risk Assessment Tool (FRAX) was adapted using studies with a small number of patients, and there are only a few external validation studies that present limitations. In this prospective cohort study, we compared the performance of FRAX and a simple age and sex model. We used data from the ESOSVAL cohort, a cohort composed of a Mediterranean population of 11,035 women and men aged 50 years and over, followed for up to 8 years, to compare the discrimination, calibration, and reclassification of FRAX calibrated for Spain and a logistic model including only age and sex as variables. We found virtually identical AUC, 83.55% for FRAX (CI 95%: 80.46, 86.63) and 84.10% for the age and sex model (CI 95%: 80.91, 87.29), and there were similar observed-to-predicted ratios. In the reclassification analyses, patients with a hip fracture that were reclassified correctly as high risk by FRAX, compared to the age and sex model, were -2.86%, using either the 3% threshold or the observed incidence, 1.54% (95%CI: -8.44, 2.72 for the 3% threshold; 95%CI: -7.68, 1.97 for the incidence threshold). Remarkably simple and inexpensive tools that are easily transferable into electronic medical record environments may offer a comparable predictive ability to that of FRAX.
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