title: Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain.
abstract: BACKGROUND
  Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age.Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years.
  
  
  METHODS
  To assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations.
  
  
  METHODS
  Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors.
  
  
  METHODS
  At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site.
  
  
  CONCLUSIONS
  Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a method for calculating the risk (probability) of fractures using the FRAX™ tool is foreseeable in Spain and this would justify a study such as this to allow the necessary adjustments in calibration of the parameters included in the logarithmic formula constituted by FRAX™.
authors.affiliation: Department of Medicine, Universitat Autònoma de Barcelona, Psg Vall d'Hebrón 119-129, 08035 Barcelona, Spain. rafael.azagra@uab.cat
authors.forename: Rafael
authors.initials: R
authors.lastname: Azagra
authors.forename: Genís
authors.initials: G
authors.lastname: Roca
authors.forename: Gloria
authors.initials: G
authors.lastname: Encabo
authors.forename: Daniel
authors.initials: D
authors.lastname: Prieto
authors.forename: Amada
authors.initials: A
authors.lastname: Aguyé
authors.forename: Marta
authors.initials: M
authors.lastname: Zwart
authors.forename: Sílvia
authors.initials: S
authors.lastname: Güell
authors.forename: Núria
authors.initials: N
authors.lastname: Puchol
authors.forename: Emili
authors.initials: E
authors.lastname: Gene
authors.forename: Enrique
authors.initials: E
authors.lastname: Casado
authors.forename: Pilar
authors.initials: P
authors.lastname: Sancho
authors.forename: Sílvia
authors.initials: S
authors.lastname: Solà
authors.forename: Pere
authors.initials: P
authors.lastname: Torán
authors.forename: Milagros
authors.initials: M
authors.lastname: Iglesias
authors.forename: Victòria
authors.initials: V
authors.lastname: Sabaté
authors.forename: Francesc
authors.initials: F
authors.lastname: López-Expósito
authors.forename: Sergio
authors.initials: S
authors.lastname: Ortiz
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Fernandez
authors.forename: Adolf
authors.initials: A
authors.lastname: Diez-Perez
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys / Q000379:methods* / Q000592:standards / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012984:Software / Q000592:standards* / Q000639:trends; D012986:Software Validation; D013030:Spain / Q000453:epidemiology