Invited Commentary
December 14, 2009

Should There Be a Fracas Over FRAX and Other Fracture Prediction Tools?Comment on “A Comparison of Prediction Models for Fractures in Older Women”

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Intern Med. 2009;169(22):2094-2095. doi:10.1001/archinternmed.2009.2094

Clinical practice guidelines regarding when to initiate osteoporosis treatment have evolved from the use of bone mineral density (BMD) thresholds to a more complex consideration of the patient's 10-year absolute fracture risk.1 There are sound reasons for this shift: most fractures occur in patients with BMD T scores above −2.5, and other clinical risk factors, especially age, affect fracture risk.1 Assuming equal relative treatment efficacy, prescribing therapy for a patient with a higher 10-year fracture risk will result in a greater absolute fracture reduction and be more cost-effective for society.

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