Validation of FRC, a Fracture Risk Assessment Tool, in a Cohort of Older Men: The Osteoporotic Fractures in Men (MrOS) Study

Bruce Ettinger, Hau Liu, Terri Blackwell, Andrew R. Hoffman, Kristine E. Ensrud, Eric S. Orwoll

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

We evaluated the performance of the Fracture Risk Calculator (FRC) in 5893 men who participated in the baseline visit (March 2000-April 2002) of the Osteoporotic Fractures in Men Study. FRC estimates for 10-yr hip and major osteoporotic (hip, clinical spine, forearm, and shoulder) fractures were calculated and compared with observed 10-yr fracture probabilities. Possible enhancement of the tool's performance when bone mineral density (BMD) was included was evaluated by comparing areas under receiver operating characteristic curves and by Net Reclassification Improvement (NRI). A total of 5893 men were followed-up for an average of 8.4. yr. For most quintiles of predicted fracture risk, the ratios of observed to predicted probabilities were close to unity. Area under the curves improved when BMD was included (p< 0.001; 0.79 vs 0.71 for hip fracture and 0.70 vs 0.66 for major osteoporotic fracture, respectively). Using National Osteoporosis Foundation clinical treatment thresholds, BMD inclusion increased NRI significantly, 8.5% (p< 0.01) for hip and 4.0% (p=0.01) for major osteoporotic fracture. We conclude that the FRC calibrates well with hip and major osteoporotic fractures observed among older men. Further, addition of BMD to the fracture risk calculation improves the tool's performance.

Original languageEnglish (US)
Pages (from-to)334-342
Number of pages9
JournalJournal of Clinical Densitometry
Volume15
Issue number3
DOIs
StatePublished - Jul 2012

Keywords

  • Fracture
  • Men
  • Prediction
  • Risk assessment

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Radiology Nuclear Medicine and imaging

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