Interpretation and use of FRAX in clinical practice

J. A. Kanis, D. Hans, C. Cooper, S. Baim, J. P. Bilezikian, N. Binkley, J. A. Cauley, J. E. Compston, B. Dawson-Hughes, G. El-Hajj Fuleihan, H. Johansson, W. D. Leslie, E. M. Lewiecki, M. Luckey, A. Oden, S. E. Papapoulos, C. Poiana, R. Rizzoli, D. A. Wahl, E. V. McCloskey

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371 Scopus citations


Summary: The introduction of the WHO FRAX® algorithms has facilitated the assessment of fracture risk on the basis of fracture probability. Its use in fracture risk prediction has strengths, but also limitations of which the clinician should be aware and are the focus of this review Introduction: The International Osteoporosis Foundation (IOF) and the International Society for Clinical Densitometry (ISCD) appointed a joint Task Force to develop resource documents in order to make recommendations on how to improve FRAX and better inform clinicians who use FRAX. The Task Force met in November 2010 for 3 days to discuss these topics which form the focus of this review. Methods: This study reviews the resource documents and joint position statements of ISCD and IOF. Results: Details on the clinical risk factors currently used in FRAX are provided, and the reasons for the exclusion of others are provided. Recommendations are made for the development of surrogate models where country-specific FRAX models are not available. Conclusions: The wish list of clinicians for the modulation of FRAX is large, but in many instances, these wishes cannot presently be fulfilled; however, an explanation and understanding of the reasons may be helpful in translating the information provided by FRAX into clinical practice.

Original languageEnglish (US)
Pages (from-to)2395-2411
Number of pages17
JournalOsteoporosis International
Issue number9
StatePublished - Sep 2011


  • Bone mineral density
  • Clinical risk factors
  • Fracture probability
  • Risk assessment

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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