Evidence map›Paper›PMID 36357621›Full record

ArticleArchives of osteoporosis2022

Osteoporosis treatment in Austria-assessment of FRAX-based intervention thresholds for high and very high fracture risk.

Hans P Dimai, Helena Johansson, Nicholas C Harvey, Mattias Lorentzon, Enwu Liu, Liesbeth Vandenput, Astrid Fahrleitner-Pammer, Peter Pietschmann, Christian Muschitz, Eugene V McCloskey and 1 more

Abstract read
In one paragraph

Article in Archives of osteoporosis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Bone Material Properties in Male Idiopathic Osteoporosis.Calcified tissue international · 2025
    Article
  4. Characteristics and treatment options of 272,152 geriatric patients with very high and high 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 · 2025
    Article
  5. A surrogate FRAX model for Mongolia.Archives of osteoporosis · 2025
    Article
  6. Sentinel fracture: the necessity of improved post-fracture care.Wiener medizinische Wochenschrift (1946) · 2025
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hans P DimaiDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Helena JohanssonMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Mattias LorentzonMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Enwu LiuDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Liesbeth VandenputMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Astrid Fahrleitner-PammerDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Peter PietschmannInstitute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
Christian Muschitz2nd Medical Department, Vinforce, St. Vincent Hospital Vienna, Vienna, Austria.
Eugene V McCloskeyCentre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
John A KanisMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.pontefract@shef.ac.uk.

Funding

Medical Research Council MC_PC_21003Medical Research Council MC_PC_21022Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/2
6 · The paper itself

Abstract

The adoption of the management pathway proposed by the National Osteoporosis Guideline Group (NOGG), UK applied using the Austrian FRAX® tool in a referral population of Austrian women categorises 22-29% of women age 40 years or more eligible for treatment of whom 28-34% are classified at very high risk. PURPOSE: The aim of this study is to provide a reference document for the further development of existing guidelines for the management of osteoporosis in Austria, considering FRAX-based intervention thresholds for high and very high fracture risk.

methodsThe model development was based on two Austrian hospital referral cohorts. Baseline information was collected to compute the 10-year probability (using the Austrian FRAX model) of a major osteoporotic fracture (MOF) and hip fracture both with and without the inclusion of femoral neck bone mineral density (BMD). Assessment thresholds for BMD testing were defined, as well as intervention thresholds. In addition, thresholds that characterise men and women at high and very high fracture risk were established. The management pathway followed that currently recommended by the UK National Osteoporosis Guideline Group (NOGG).

resultsThe two cohorts comprised a total of 1306 women and men with a mean age of 66.7 years. Slightly more than 50% were eligible for treatment by virtue of a prior fragility fracture. In those women without a prior fracture, 22% (n = 120) were eligible for treatment based on MOF probabilities. Of these, 28% (n = 33) were found to be at very high risk. When both MOF and hip fracture probabilities were used to characterise risk, 164 women without a prior fracture were eligible for treatment (29%). Of these, 34% (n = 56) were found to be at very high risk. Fewer men without prior fracture were eligible for treatment compared with women.

conclusionThe management pathway as currently outlined is expected to reduce inequalities in patient management. The characterisation of very high risk may aid in the identification of patients suitable for treatment with osteoanabolic agents.

Indexed as

Hip FracturesOsteoporosisOsteoporotic FracturesAdultAgedAustriaBone DensityFemaleHumansMaleRisk AssessmentRisk FactorsAustriaFRAXHigh riskIntervention thresholdVery high risk

Identifiers

PMID36357621
PMCPMC9649455

What OpenQuestion holds

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Registered trials

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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.