The importance and applications of absolute fracture risk estimation in clinical practice and research.

摘要

Introduction:Currently we are facing a universal shift towards the use of absolute fracture risk estimation in the field of osteoporosis research and clinical practice guidelines. Recent attempts by the World Health Organization Scientific Group for assessment of osteoporosis at the primary health care level have resulted in a clinical tool for the estimation of a 10-year absolute risk of fracture in different populations [1,2]. This online tool, namely FRAX™, aims to shift the previous clinical practice (which was mainly based on defining osteoporosis using a single bone density assessment) to a more clinically relevant practice which combines information gained from clinical risk factors and bone mineral density (BMD) measurement to an estimate of absolute fracture risk and categorizes patients using this measure. The field is open now to medical researchers working on osteoporosis assessment and diagnosis who can either try to estimate and validate the 10-year absolute risk figures in their populations (using various epidemiological study designs and biostatistical approaches) or try to calculate country-specific risk thresholds for patient categorization (using principles of health economics and mathematical modeling). Clinicians also need to familiarize themselves with the concept and try to utilize the upcoming results in their clinical practice.