Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan.
Epidemiology
FRAX
Fracture probability
Hip fracture
Major osteoporotic fracture
Risk assessment
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
10
02
2022
accepted:
18
05
2022
pubmed:
1
6
2022
medline:
12
10
2022
entrez:
31
5
2022
Statut:
ppublish
Résumé
We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
Identifiants
pubmed: 35639106
doi: 10.1007/s00198-022-06435-6
pii: 10.1007/s00198-022-06435-6
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2103-2136Subventions
Organisme : Medical Research Council
ID : MC_UP_A620_1015
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12011/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UP_A620_1014
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_21003
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0400491
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585819
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_21022
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12011/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_21000
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585827
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585824
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_21001
Pays : United Kingdom
Informations de copyright
© 2022. International Osteoporosis Foundation and National Osteoporosis Foundation.
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