Commonly used prediction tool underestimated vertebral fracture risk in some cases
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Key takeaways:
- The assessment tool may underestimate the risk of some vertebral fractures and subsequent clinical fractures.
- Researchers noted the use of multipliers restored calibration of the tool.
Published results showed the validated fracture risk assessment tool, known as FRAX, may underestimate the risk of some vertebral fractures and subsequent clinical fractures, such as major osteoporotic fractures and hip fractures.
To assess the calibration of FRAX, Carrie Ye, MD, and colleagues analyzed vertebral fracture assessment (VFA) using DXA in 11,766 patients who underwent surgery for a VFA-identified fracture from 2010 to 2018.
At a mean observation time of 3.8 years, researchers found FRAX was well calibrated in patients with negative VFA results; however, FRAX “significantly underestimated” risk of major osteoporotic fracture and hip fracture in patients with VFA-identified fractures. In patients with a prior non-VFA-detected clinical fracture, FRAX underestimated major osteoporotic fracture risk by 53% and hip fracture risk by 76%.
“Results of this prognostic study confirmed that a vertebral fracture detected on VFA identified a situation in which FRAX significantly underestimated fracture risk,” the researchers wrote in the study.
However, they noted the use of multipliers for major osteoporotic fracture and hip fracture restored calibration of FRAX and improved the agreement between observed and predicted VFA-identified fractures.
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