20. The optimal thresholds of the FRAX (without BMD) using fracture risk assessment tool to predict the risk of osteoporosis in postmenopausal women
Main Article Content
Abstract
FRAX (Fracture Risk Assessment Tool) is an effective tool for predicting osteoporosis with high sensitivity and specificity. FRAX was validated and adapted to different countries. The objective of the study was to find the optimal cutoff of the FRAX model (without BMD) in predicting the risk of osteoporosis in postmenopausal women. We conducted a cross-sectional study in 396 postmenopausal women at the People's Hospital 115 from December 2021 to June 2022. Bone mineral density was measured using dual-energy X-ray absorptiometry (DXA). The results show that the FRAX (without BMD) has good accuracy in predicting osteoporosis, with the areas under the ROC curves of 0.84 and 0.85 for FRAX - MOFP (without BMD) and FRAX - HF (without BMD), respectively. The optimal cutoff of FRAX - MOFP (without BMD) was 7.8%, with sensitivity of 64.2%, specificity of 89.2%, PPV of 89.1%, and NP of 64.5%. For FRAX - HF (without BMD), the optimal cut-off was 2.1%, with sensitivity of 71.6%, specificity of 85.0%, PPV of 79.2% and NPV of 75.1%. In conclusion, FRAX (without BMD) was a reliable tool for predicting osteoporosis in our study population.
Article Details
Keywords
osteoporosis, postmenopausal osteoporosis, FRAX (without BMD)
References
2. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report. WHO Study Group. Osteoporosis international. Nov 1994;4(6):368-81.
3. Kanis JA, Oden A, et al. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporosis international. Aug 2007;18(8):1033-46.
4. Compston J, Bowring C, et al. Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas. Aug 2013;75(4):392-6.
5. Kanis JA, Harvey NC, et al. A systematic review of intervention thresholds based on FRAX : A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos. 2016;11(1):25-25.
6. Gregson CL, Armstrong DJ, et al. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. Apr 5 2022;17(1):58.
7. Chandran M, Chin YA, et al. Comparison of the Osteoporosis Self-Assessment Tool for Asians and the fracture risk assessment tool - FRAX to identify densitometric defined osteoporosis: A discriminatory value analysis in a multi-ethnic female population in Southeast Asia. Osteoporos Sarcopenia. Jun 2020;6(2):53-58.
8. Ho-Pham LT, Nguyen UD, Pham HN, Nguyen ND, Nguyen TV. Reference ranges for bone mineral density and prevalence of osteoporosis in Vietnamese men and women. BMC musculoskeletal disorders. Aug 10 2011;12:182.
9. Bui MH, Dao PT, et al. Evaluation of community-based screening tools for the early screening of osteoporosis in postmenopausal Vietnamese women. PloS one. 2022;17(4):e0266452.
10. Hoang DK, Doan MC, Mai LD, Ho-Le TP, Ho-Pham LT. Burden of osteoporosis in Vietnam: An analysis of population risk. PloS one. 2021;16(6):e0252592.
11. Ho-Pham LT, Doan MC, Van LH, Nguyen TV. Development of a model for identification of individuals with high risk of osteoporosis. Arch Osteoporos. Jul 22 2020;15(1):111.
12. Fan Z, Li X, et al. Comparison of OSTA, FRAX and BMI for Predicting Postmenopausal Osteoporosis in a Han Population in Beijing: A Cross Sectional Study. Clinical interventions in aging. 2020;15:1171-1180.