Fracture prediction and calibration of a Canadian FRAX® tool: A population-based report from CaMos

L. A. Fraser; L. Langsetmo; C. Berger; G. Ioannidis; D. Goltzman; J. D. Adachi; A. Papaioannou; R. Josse; C. S. Kovacs; W. P. Olszynski; T. Towheed; D. A. Hanley; S. M. Kaiser; J. Prior; S. Jamal; N. Kreiger; J. P. Brown; H. Johansson; A. Oden; E. McCloskey; J. A. Kanis; W. D. Leslie

doi:10.1007/s00198-010-1465-1

Fracture prediction and calibration of a Canadian FRAX® tool: A population-based report from CaMos

L. A. Fraser, L. Langsetmo, C. Berger, G. Ioannidis, D. Goltzman, J. D. Adachi, A. Papaioannou, R. Josse, C. S. Kovacs, W. P. Olszynski, T. Towheed, D. A. Hanley, S. M. Kaiser, J. Prior, S. Jamal, N. Kreiger, J. P. Brown, H. Johansson, A. Oden, E. McCloskeyJ. A. Kanis, W. D. Leslie

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

136 Scopus citations

Abstract

Summary: A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. Introduction: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). Methods: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N=4,778) and men (N=1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. Results: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. Conclusion: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.

Original language	English (US)
Pages (from-to)	829-837
Number of pages	9
Journal	Osteoporosis International
Volume	22
Issue number	3
DOIs	https://doi.org/10.1007/s00198-010-1465-1
State	Published - Mar 2011

Bibliographical note

Funding Information:
We thank all those participants in CaMos whose careful responses and attendance made this analysis possible. Dr. Fraser is supported by the University of Western Ontario Resident Research Career Development Program. The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research (CIHR); Merck Frosst Canada Ltd.; Eli Lilly Canada Inc.; Novartis Pharmaceuticals Inc.; The Alliance: sanofi-aventis & Procter and Gamble Pharmaceuticals Canada Inc.; Servier Canada Inc.; Amgen Canada Inc.; The Dairy Farmers of Canada; and The Arthritis Society.

Keywords

Canada
FRAX
Fracture
Fracture prediction
Osteoporosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00198-010-1465-1

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Fraser, L. A., Langsetmo, L., Berger, C., Ioannidis, G., Goltzman, D., Adachi, J. D., Papaioannou, A., Josse, R., Kovacs, C. S., Olszynski, W. P., Towheed, T., Hanley, D. A., Kaiser, S. M., Prior, J., Jamal, S., Kreiger, N., Brown, J. P., Johansson, H., Oden, A., ... Leslie, W. D. (2011). Fracture prediction and calibration of a Canadian FRAX® tool: A population-based report from CaMos. Osteoporosis International, 22(3), 829-837. https://doi.org/10.1007/s00198-010-1465-1

Fraser, LA, Langsetmo, L, Berger, C, Ioannidis, G, Goltzman, D, Adachi, JD, Papaioannou, A, Josse, R, Kovacs, CS, Olszynski, WP, Towheed, T, Hanley, DA, Kaiser, SM, Prior, J, Jamal, S, Kreiger, N, Brown, JP, Johansson, H, Oden, A, McCloskey, E, Kanis, JA & Leslie, WD 2011, 'Fracture prediction and calibration of a Canadian FRAX® tool: A population-based report from CaMos', Osteoporosis International, vol. 22, no. 3, pp. 829-837. https://doi.org/10.1007/s00198-010-1465-1

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title = "Fracture prediction and calibration of a Canadian FRAX{\textregistered} tool: A population-based report from CaMos",

abstract = "Summary: A new Canadian WHO fracture risk assessment (FRAX{\textregistered}) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. Introduction: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX{\textregistered}) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). Methods: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N=4,778) and men (N=1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. Results: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. Conclusion: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.",

keywords = "Canada, FRAX, Fracture, Fracture prediction, Osteoporosis",

author = "Fraser, {L. A.} and L. Langsetmo and C. Berger and G. Ioannidis and D. Goltzman and Adachi, {J. D.} and A. Papaioannou and R. Josse and Kovacs, {C. S.} and Olszynski, {W. P.} and T. Towheed and Hanley, {D. A.} and Kaiser, {S. M.} and J. Prior and S. Jamal and N. Kreiger and Brown, {J. P.} and H. Johansson and A. Oden and E. McCloskey and Kanis, {J. A.} and Leslie, {W. D.}",

note = "Funding Information: We thank all those participants in CaMos whose careful responses and attendance made this analysis possible. Dr. Fraser is supported by the University of Western Ontario Resident Research Career Development Program. The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research (CIHR); Merck Frosst Canada Ltd.; Eli Lilly Canada Inc.; Novartis Pharmaceuticals Inc.; The Alliance: sanofi-aventis & Procter and Gamble Pharmaceuticals Canada Inc.; Servier Canada Inc.; Amgen Canada Inc.; The Dairy Farmers of Canada; and The Arthritis Society. ",

year = "2011",

month = mar,

doi = "10.1007/s00198-010-1465-1",

language = "English (US)",

volume = "22",

pages = "829--837",

journal = "Osteoporosis International",

issn = "0937-941X",

publisher = "Springer London",

number = "3",

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TY - JOUR

T1 - Fracture prediction and calibration of a Canadian FRAX® tool

T2 - A population-based report from CaMos

AU - Fraser, L. A.

AU - Langsetmo, L.

AU - Berger, C.

AU - Ioannidis, G.

AU - Goltzman, D.

AU - Adachi, J. D.

AU - Papaioannou, A.

AU - Josse, R.

AU - Kovacs, C. S.

AU - Olszynski, W. P.

AU - Towheed, T.

AU - Hanley, D. A.

AU - Kaiser, S. M.

AU - Prior, J.

AU - Jamal, S.

AU - Kreiger, N.

AU - Brown, J. P.

AU - Johansson, H.

AU - Oden, A.

AU - McCloskey, E.

AU - Kanis, J. A.

AU - Leslie, W. D.

N1 - Funding Information: We thank all those participants in CaMos whose careful responses and attendance made this analysis possible. Dr. Fraser is supported by the University of Western Ontario Resident Research Career Development Program. The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research (CIHR); Merck Frosst Canada Ltd.; Eli Lilly Canada Inc.; Novartis Pharmaceuticals Inc.; The Alliance: sanofi-aventis & Procter and Gamble Pharmaceuticals Canada Inc.; Servier Canada Inc.; Amgen Canada Inc.; The Dairy Farmers of Canada; and The Arthritis Society.

PY - 2011/3

Y1 - 2011/3

N2 - Summary: A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. Introduction: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). Methods: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N=4,778) and men (N=1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. Results: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. Conclusion: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.

AB - Summary: A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures. Introduction: The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos). Methods: A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N=4,778) and men (N=1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables. Results: Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures. Conclusion: The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.

KW - Canada

KW - FRAX

KW - Fracture

KW - Fracture prediction

KW - Osteoporosis

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Fracture prediction and calibration of a Canadian FRAX® tool: A population-based report from CaMos

Abstract

Bibliographical note

Keywords

UN SDGs

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