Observational studyJournal of general internal medicine2019
Predicting Fracture Risk in Younger Postmenopausal Women: Comparison of the Garvan and FRAX Risk Calculators in the Women's Health Initiative Study.
Observational study in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- In vivo mechanical assessment of cortical bone rigidity enhances fracture discrimination beyond DXA in postmenopausal women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Approach to osteoporosis diagnosis and fracture risk management in primary care.Canadian family physician Medecin de famille canadien · 2026Review
- In Vivo Mechanical Assessment of Cortical Bone Rigidity Enhances Fracture Discrimination Beyond DXA in Postmenopausal Women.medRxiv : the preprint server for health sciences · 2025Article
- Fracture risk in Korean postmenopausal women: The influence of BMI, age, and bone density.Osteoporosis and sarcopenia · 2025Article
- Identifying Younger Postmenopausal Women With Osteoporosis Using USPSTF-Recommended Osteoporosis Risk Assessment Tools.JAMA network open · 2025Article
- Race-specific FRAX models are evidence-based and support equitable care: a response to the ASBMR Task Force report on Clinical Algorithms for Fracture Risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Risk analysis for subsequent fracture of osteoporotic fractures in Chinese women over age 60: a nationwide cross-sectional study.Scientific reports · 2024Article
- Fracture risk prediction in postmenopausal women from GO Study: the comparison between FRAX, Garvan, and POL-RISK algorithms.Archives of osteoporosis · 2024Article
- Enhanced osteoporotic fracture prediction in postmenopausal women using Bayesian optimization of machine learning models with genetic risk score.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Establishment and validation of a nomogram clinical prediction model for osteoporosis in senile patients with type 2 diabetes mellitus.Scientific reports · 2024Article
- Electronic Health Records (EHRs) Can Identify Patients at High Risk of Fracture but Require Substantial Race Adjustments to Currently Available Fracture Risk Calculators.Journal of general internal medicine · 2023Article
- Optimal fracture prediction thresholds for therapy onset, established from FRAX and Garvan algorithms: a longitudinal observation of the population representative female cohort from the RAC-OST-POL Study.Archives of osteoporosis · 2023Article
- Development and validation of a risk prediction model for osteoporosis in elderly patients with type 2 diabetes mellitus: a retrospective and multicenter study.BMC geriatrics · 2023Article
- Bone density and trabecular bone score to predict fractures in adults aged 20-39 years: a registry-based study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Bone mineral density and fractures in patients with rheumatoid arthritis: the DXA-HIP project.Rheumatology advances in practice · 2023Article
- Comparison between real-world practice and application of the FRAX algorithm in the treatment of osteoporosis.Aging clinical and experimental research · 2022Article
- Current Status of the Diagnosis and Management of Osteoporosis.International journal of molecular sciences · 2022Review
- Comparison of fracture risk calculators in elderly fallers: a hospital-based cross-sectional study.BMJ open · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundGuidelines recommend fracture risk assessment in postmenopausal women aged 50-64, but the optimal method is unknown.
objectivesTo compare discrimination and calibration of the Fracture Risk Assessment Tool (FRAX) and Garvan fracture risk calculator for predicting fractures in postmenopausal women aged 50-64 at baseline.
designProspective observational study.
participantsSixty-three thousand seven hundred twenty-three postmenopausal women aged 50-64 years participating in the Women's Health Initiative Observational Study and Clinical Trials. MAIN MEASURES: Incident hip fractures and major osteoporotic fractures (MOF) during 10-year follow-up. Calculated FRAX- and Garvan-predicted hip fracture and MOF fracture probabilities. KEY
resultsThe observed 10-year hip fracture probability was 0.3% for women aged 50-54 years (n = 14,768), 0.6% for women aged 55-59 years (n = 22,442), and 1.1% for women aged 60-64 years (n = 25,513). At sensitivity thresholds ≥ 80%, specificity of both tools for detecting incident hip fracture during 10 years of follow-up was low: Garvan 30.6% (95% confidence interval [CI] 30.3-31.0%) and FRAX 43.1% (95% CI 42.7-43.5%). At maximal area under the receiver operating characteristic curve (AUC(c), 0.58 for Garvan, 0.65 for FRAX), sensitivity was 16.0% (95% CI 12.7-19.4%) for Garvan and 59.2% (95% CI 54.7-63.7%) for FRAX. At AUC(c) values, sensitivity was lower in African American and Hispanic women than among white women and lower in women aged 50-54 than those 60-64 years old. Observed hip fracture probabilities were similar to FRAX-predicted probabilities but greater than Garvan-predicted probabilities. At AUC(c) values (0.56 for both tools), sensitivity for identifying MOF was also low (range 26.7-46.8%). At AUC(c) values (0.55 for both tools), sensitivity for identifying any clinical fracture ranged from 18.1 to 34.0%.
conclusionsIn postmenopausal women aged 50-64 years, the FRAX and Garvan fracture risk calculator discriminate poorly between women who do and do not experience fracture during 10-year follow-up. There is no useful threshold for either tool.
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