The discriminative ability of FRAX and possible FRAX-based intervention thresholds in the Chinese population: a 10-year study

Abstract

Abstract Purpose Our study aims to assess the performance of FRAX and explored possible Chinese-specific intervention thresholds. Methods Four hundred and sixty-nine participants were observed for 10 years. Using FRAX with bone mineral density (BMD), 10-year possibilities of hip fracture (HF) and major osteoporotic fracture (MOF) were calculated. New fractures were self-reported. Using the incidence of new fractures as the gold standard, discrimination of FRAX was analyzed by receiver operating characteristic (ROC) curve. We also found possible intervention thresholds by using the greatest Youden index. Results Forty-nine MOFs were self-reported, including 5 HFs. ROC analysis showed the area under the curve (AUC) for FRAX-based MOF probability was 0.683, and the cut-off value was 2.95%. The sensitivity was 59.2% and the specificity was 67.6%. For prediction of HF, the AUC for FRAX-based HF probability was 0.776, and the cut-off value was 0.45%. The sensitivity was 100% and the specificity was 44.6%. Conclusion FRAX with BMD has the ability to discriminate osteoporotic fractures. FRAX-based MOF probability of 2.95% and HF probability of 0.45% can be considered as possible intervention thresholds.