Summary
A country-specific FRAX model has been developed
for the Ukraine to replace the Austrian model hitherto
used. Comparison of the Austrian and Ukrainian models indicated
that the former markedly overestimated fracture probability
whilst correctly stratifying risk.
Introduction
FRAX has been used to estimate osteoporotic
fracture risk since 2009. Rather than using a surrogate model,
the Austrian version of FRAX was adopted for clinical practice.
Since then, data have become available on hip fracture
incidence in the Ukraine.
Methods
The incidence of hip fracture was computed from three
regional estimates and used to construct a country-specific
FRAX model for the Ukraine. The model characteristics were
compared with those of the Austrian FRAX model, previously
used in Ukraine by using all combinations of six risk factors and
eight values of BMD (total number of combinations =512).
Results
The relationship between the probabilities of a major
fracture derived from the two versions of FRAX indicated a
close correlation between the two estimates (r > 0.95). The
Ukrainian version, however, gave markedly lower probabilities
than the Austrian model at all ages. For a major osteoporotic
fracture, the median probability was lower by 25% at age
50 years and the difference increased with age. At the age of
60, 70 and 80 years, the median value was lower by 30, 53 and
65%, respectively. Similar findings were observed for men
and for hip fracture.
Conclusion
The Ukrainian FRAX model should enhance accuracy
of determining fracture probability among the
Ukrainian population and help to guide decisions about treatment.
The study also indicates that the use of surrogate FRAX
models or models from other countries, whilst correctly stratifying
risk, may markedly over or underestimate the absolute
fracture probability.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)