ArticlePloS one2013
FRAX®: prediction of major osteoporotic fractures in women from the general population: the OPUS study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 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
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Predictive value of BMD for hip and other fractures: a meta-analysis to update FRAX.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
- A systematic review on the performance of fracture risk assessment tools: FRAX, DeFRA, FRA-HS.Journal of endocrinological investigation · 2023Pooled it
- Executive summary: Italian guidelines for diagnosis, risk stratification, and care continuity of fragility fractures 2021.Frontiers in endocrinology · 2023Pooled it
- Performance of predictive tools to identify individuals at risk of non-traumatic fracture: a systematic review, meta-analysis, and meta-regression.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- Validation of fracture-derived polygenic scores with FRAX for fracture risk prediction in postmenopausal women.Archives of osteoporosis · 2026Article
- Advanced Bayesian BMD-Derived Genome-Wide Polygenic Scores Enhance Clinical FRAX-Based Fracture Risk Prediction in Postmenopausal Women.Calcified tissue international · 2026Article
- Underestimation of fracture risk by conventional FRAX thresholds in axial spondyloarthritis: a proposal for disease-specific thresholds.Therapeutic advances in musculoskeletal disease · 2026Article
- Concordance of the Fracture Risk Assessment Tool With and Without Bone Mineral Density and Its Role in Predicting Postoperative Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery.Neurosurgery practice · 2025Article
- Bayesian Genome-wide Polygenic Score Integration with FRAX for Enhanced Fracture Risk Prediction in Postmenopausal Women.medRxiv : the preprint server for health sciences · 2025Article
- Fractures in Hereditary Neuromuscular Disorders: Frequency, Risk Factors, and Implications.European journal of neurology · 2025Article
- Validity of Major Osteoporotic Fracture Diagnoses in the Danish National Patient Registry.Clinical epidemiology · 2024Article
- Development and validation of the fall-related injury risk in nursing homes (INJURE-NH) prediction tool.Journal of the American Geriatrics Society · 2023Article
- The clinical utility of the BMD-related comprehensive genome-wide polygenic score in identifying individuals with a high risk of osteoporotic fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Article
- Prediction Models for Osteoporotic Fractures Risk: A Systematic Review and Critical Appraisal.Aging and disease · 2022Review
- Axial Transmission: Techniques, Devices and Clinical Results.Advances in experimental medicine and biology · 2022Article
- Osteoporosis Screening Is Often Indicated but Overlooked Prior to Rotator Cuff Repair.Arthroscopy, sports medicine, and rehabilitation · 2021Article
- Bone Mineral Density: Clinical Relevance and Quantitative Assessment.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2021Review
- Comparing three machine learning approaches to design a risk assessment tool for future fractures: predicting a subsequent major osteoporotic fracture in fracture patients with osteopenia and osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- The International Collaborative Gaucher Group GRAF (Gaucher Risk Assessment for Fracture) score: a composite risk score for assessing adult fracture risk in imiglucerase-treated Gaucher disease type 1 patients.Orphanet journal of rare diseases · 2021Article
Corrections and comments
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Authors and funding
8 authors at 7 institutions in 4 countries.
Funding
Abstract
purposesThe aim of this study was to analyse how well FRAX® predicts the risk of major osteoporotic and vertebral fractures over 6 years in postmenopausal women from general population. PATIENTS AND
methodsThe OPUS study was conducted in European women aged above 55 years, recruited in 5 centers from random population samples and followed over 6 years. The population for this study consisted of 1748 women (mean age 74.2 years) with information on incident fractures. 742 (43.1%) had a prevalent fracture; 769 (44%) and 155 (8.9%) of them received an antiosteoporotic treatment before and during the study respectively. We compared FRAX® performance with and without bone mineral density (BMD) using receiver operator characteristic (ROC) c-statistical analysis with ORs and areas under receiver operating characteristics curves (AUCs) and net reclassification improvement (NRI).
results85 (4.9%) patients had incident major fractures over 6 years. FRAX® with and without BMD predicted these fractures with an AUC of 0.66 and 0.62 respectively. The AUC were 0.60, 0.66, 0.69 for history of low trauma fracture alone, age and femoral neck (FN) BMD and combination of the 3 clinical risk factors, respectively. FRAX® with and without BMD predicted incident radiographic vertebral fracture (n = 65) with an AUC of 0.67 and 0.65 respectively. NRI analysis showed a significant improvement in risk assignment when BMD is added to FRAX®.
conclusionsThis study shows that FRAX® with BMD and to a lesser extent also without FN BMD predict major osteoporotic and vertebral fractures in the general population.
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