ArticleBone2022
Reverse engineering the FRAX algorithm: Clinical insights and systematic analysis of fracture risk.
Article in Bone, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2024 Royal Australian College of General Practitioners and Healthy Bones Australia guideline for osteoporosis management and fracture prevention in postmenopausal women and men over 50 years of age.The Medical journal of Australia · 2025Guideline
- Deep learning-based CT-derived vertebral bone mineral density and metformin therapy: a longitudinal study in the Multi-Ethnic Study of Atherosclerosis.Skeletal radiology · 2026Article
- Fragility fractures and risk factors in a peritoneal dialysis setting.Archives of osteoporosis · 2026Article
- Ten-year re-validation of the fracture risk assessment tool (FRAX®) in Taiwan.Archives of osteoporosis · 2026Article
- An enhanced Fracture Risk Evaluation Model (FREM) using national health data on morbidity and medications.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Article
- Management of aromatase inhibitor-associated bone loss (AIBL) in women with hormone-sensitive breast cancer: An updated joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS, and SIOG.Journal of bone oncology · 2025Review
- Assessment of the 10-Year Probability of Fracture Using Femoral Neck (FRAX) and Lumbar BMD (FRAXplus) in Menopausal Women with Non-Functioning Adrenal Tumors: Where We Stand Today (A Study-Focused Analysis).Journal of clinical medicine · 2025Article
- A novel clinical prediction model for hip fractures: a development and validation study in the total population of Sweden.EClinicalMedicine · 2024Article
- Decomposing and simplifying the Fracture Risk Assessment Tool-a module from the Taiwan-specific calculator.JBMR plus · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
The Fracture Risk Assessment Tool (FRAX) is a computational tool developed to predict the 10-year probability of hip fracture and major osteoporotic fracture based on inputs of patient characteristics, bone mineral density (BMD), and a set of seven clinical risk factors. While the FRAX tool is widely available and clinically validated, its underlying algorithm is not public. The relative contribution and necessity of each input parameter to the final FRAX score is unknown. We systematically collected hip fracture risk scores from the online FRAX calculator for osteopenic Caucasian women across 473,088 unique inputs. This dataset was used to dissect the FRAX algorithm and construct a reverse-engineered fracture risk model to assess the relative contribution of each input variable. Within the reverse-engineered model, age and T-Score were the strongest contributors to hip fracture risk, while BMI had marginal contribution. Of the clinical risk factors, parent history of fracture and ongoing glucocorticoid treatment had the largest additive effect on risk score. A generalized linear model largely recapitulated the FRAX tool with an R
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