ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2011
WHO absolute fracture risk models (FRAX): do clinical risk factors improve fracture prediction in older women without osteoporosis?
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Management of bone health in cancer survivorship: a systematic review of clinical guidelines.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Pooled it
- Pooled it
- A systematic review of intervention thresholds based on FRAX : A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation.Archives of osteoporosis · 2016Pooled it
- Limited clinical utility of a genetic risk score for the prediction of fracture risk in elderly subjects.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2015Trial
- Explainable Multimodal Machine Learning Predicts 90-Day Treatment Failure in Older Patients with Fragility Fractures of the Pelvis.Journal of clinical medicine · 2026Article
- Proportions of fall-related and insufficiency-related vertebral fractures among hospitalized older patients.Archives of osteoporosis · 2026Article
- Assessment of Osteoporotic Fracture Risk in Patients above 50 Years Using Quantitative Ultrasonography and Fracture Risk Assessment Tool: A Cross-sectional Study.Journal of orthopaedic case reports · 2026Article
- Association of trabecular texture and paraspinal muscle characteristics with prevalent vertebral fractures - QCT results from a subcohort of the AGES population.BMC musculoskeletal disorders · 2026Article
- Fracture risk scores using output from an opportunistic screen of low bone density from conventional X-ray.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Are low-trauma fractures all fragility fractures? Insights into musculoskeletal and body composition characteristics of community-dwelling post-menopausal women with a recent fracture.Aging clinical and experimental research · 2025Article
- A new cut-off value of FRAX tools as an osteoporosis screening tool for Thai geriatric population.Scientific reports · 2025Article
- Majority of hip fragility fractures among older people can be predicted by a DXA examination: an updated analysis of literature results and empirical Chinese data with a focus on the validation of the newly proposed osteofrailia criterion for men.Quantitative imaging in medicine and surgery · 2025Article
- Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune-Inflammatory-Metabolic Markers and Related Conceptual Issues.Journal of clinical medicine · 2024Article
- For older women, the majority of hip fragility fractures and radiographic vertebral fragility fractures occur among the densitometrically osteoporotic population: a literature analysis.Quantitative imaging in medicine and surgery · 2024Review
- Frailty syndrome in women with osteoporosis, should physicians consider screening? A cross-sectional study.Bone reports · 2023Article
- Article
- Trabecular Bone Score Significantly Influences Treatment Decisions in Secondary Osteoporosis.Journal of clinical medicine · 2023Article
- Short-Term Precision and Repeatability of Radiofrequency Echographic Multi Spectrometry (REMS) on Lumbar Spine and Proximal Femur: An In Vivo Study.Journal of imaging · 2023Article
- Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX.Archives of osteoporosis · 2023Article
- Associations between body composition, physical activity, and diet and radial bone microarchitecture in older adults: a 10-year population-based study.Archives of osteoporosis · 2022Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
Bone mineral density (BMD) is a strong predictor of fracture, yet most fractures occur in women without osteoporosis by BMD criteria. To improve fracture risk prediction, the World Health Organization recently developed a country-specific fracture risk index of clinical risk factors (FRAX) that estimates 10-year probabilities of hip and major osteoporotic fracture. Within differing baseline BMD categories, we evaluated 6252 women aged 65 or older in the Study of Osteoporotic Fractures using FRAX 10-year probabilities of hip and major osteoporotic fracture (ie, hip, clinical spine, wrist, and humerus) compared with incidence of fractures over 10 years of follow-up. Overall ability of FRAX to predict fracture risk based on initial BMD T-score categories (normal, low bone mass, and osteoporosis) was evaluated with receiver-operating-characteristic (ROC) analyses using area under the curve (AUC). Over 10 years of follow-up, 368 women incurred a hip fracture, and 1011 a major osteoporotic fracture. Women with low bone mass represented the majority (n = 3791, 61%); they developed many hip (n = 176, 48%) and major osteoporotic fractures (n = 569, 56%). Among women with normal and low bone mass, FRAX (including BMD) was an overall better predictor of hip fracture risk (AUC = 0.78 and 0.70, respectively) than major osteoporotic fractures (AUC = 0.64 and 0.62). Simpler models (eg, age + prior fracture) had similar AUCs to FRAX, including among women for whom primary prevention is sought (no prior fracture or osteoporosis by BMD). The FRAX and simpler models predict 10-year risk of incident hip and major osteoporotic fractures in older US women with normal or low bone mass.
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