ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2015
FRAX-based assessment and intervention thresholds--an exploration of thresholds in women aged 50 years and older in the UK.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 6 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- The 2024 UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2025Guideline
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2022Guideline
- European guidance for the diagnosis and management of osteoporosis in postmenopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Guideline
- 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
- Community-based osteoporosis prescreening using FRAX and portable pulse-echo ultrasound: a pilot study from Western Austria.Archives of osteoporosis · 2026Article
- Revised Swedish FRAX models and the establishment of age-dependent intervention thresholds.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Advancing care: optimizing osteoporosis treatment in the older and oldest old population.Aging clinical and experimental research · 2025Review
- Assessing and managing bone health and fracture risk in Parkinson's disease: the BONE PARK 2 protocol.Age and ageing · 2025Article
- A surrogate FRAX model for Mongolia.Archives of osteoporosis · 2025Article
- Cost-effectiveness intervention thresholds for romosozumab and teriparatide in the treatment of osteoporosis in the UK.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Evidence-Based Guideline for the management of osteoporosis in men.Nature reviews. Rheumatology · 2024Review
- An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis.Journal of endocrinological investigation · 2024Review
- An assessment of intervention thresholds for high fracture risk in Chile.Archives of osteoporosis · 2022Article
- Osteoporosis treatment in Austria-assessment of FRAX-based intervention thresholds for high and very high fracture risk.Archives of osteoporosis · 2022Article
- Definition and management of very high fracture risk in women with postmenopausal osteoporosis: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Association of Bone Assessment and Metabolism (ABRASSO).Archives of endocrinology and metabolism · 2022Article
- Osteoporosis in 2022: Care gaps to screening and personalised medicine.Best practice & research. Clinical rheumatology · 2022Review
- Is it time to consider population screening for fracture risk in postmenopausal women? A position paper from the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group.Archives of osteoporosis · 2022Article
- Management of patients at very high risk of osteoporotic fractures through sequential treatments.Aging clinical and experimental research · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 10 institutions in 1 country.
Funding
Abstract
unlabelledUnder current guidelines, based on prior fracture probability thresholds, inequalities in access to therapy arise especially at older ages (≥70 years) depending on the presence or absence of a prior fracture. An alternative threshold (a fixed threshold from the age of 70 years) reduces this disparity, increases treatment access and decreases the need for bone densitometry.
introductionSeveral international guidelines set age-specific intervention thresholds at the 10-year probability of fracture equivalent to a woman of average BMI with a prior fracture. At older ages (≥70 years), women with prior fracture selected for treatment are at lower average absolute risk than those selected for treatment in the absence of prior fracture, prompting consideration of alternative thresholds in this age group.
methodsUsing a simulated population of 50,633 women aged 50-90 years in the UK, with a distribution of risk factors similar to that in the European FRAX derivation cohorts and a UK-matched age distribution, the current NOGG intervention and assessment thresholds were compared to one where the thresholds remained constant from 70 years upwards.
resultsUnder current thresholds, 45.1% of women aged ≥70 years would be eligible for therapy, comprising 37.5% with prior fracture, 2.2% with high risk but no prior fracture and 5.4% selected for treatment after bone mineral density (BMD) measurement. Mean hip fracture probability was 11.3, 23.3 and 17.6%, respectively, in these groups. Under the alternative thresholds, the overall proportion of women treated increased from 45.1 to 52.9%, with 8.4% at high risk but no prior fracture and 7.0% selected for treatment after BMD measurement. In the latter group, the mean probability of hip fracture was identical to that observed in women with prior fracture (11.3%). The alternative threshold also reduced the need for BMD measurement, particularly at older ages (>80 years).
conclusionsThe alternative thresholds equilibrate fracture risk, particularly hip fracture risk, in those with or without prior fracture selected for treatment and reduce BMD usage at older ages.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.