title: Application of the fracture risk assessment tool (FRAX(®)) and determination of suitable cut-off values during primary screening in specific health check-ups in Japan.
abstract: Specific health check-ups, which do not include osteoporosis screening, are conducted more frequently than periodic osteoporosis screening in Japan. In this study, we investigated the usefulness of the fracture risk assessment tool (FRAX(®)) during specific health check-ups, evaluated the variations in its usefulness for 2 consecutive years, and determined FRAX(®) cut-off values for osteoporosis screening. FRAX(®) questionnaires were distributed to subjects who underwent specific health check-ups in 2009 and 2010 at Asahi-machi. Subjects who exhibited FRAX(®) cut-off values of ≥10 % were advised to be screened at a medical institution. Bone mineral densities (BMDs) were measured in 201 subjects in 2009 and 105 subjects in 2010 after specific health check-ups, and treatment was initiated for 79 subjects in 2009 and 24 subjects in 2010. The number of subjects examined and the rate of treatment initiation following specific health check-ups were higher than those in subjects following periodic osteoporosis screening in 2009. However, the number and the rate following specific health check-ups dropped in 2010. According to receiver operating characteristic curves analyses, the sensitivity and specificity of FRAX(®) to determine osteoporosis treatment were highest when the cut-off values were 8 % for men and 10.5 % for women. In conclusion, the combination of FRAX(®) and specific health check-ups was more useful than periodic osteoporosis screening to narrow down the subjects and to motivate them to seek follow-up. Cut-off values for specific health check-up using FRAX(®) should be approximately 8 % for men and 10.5 % for women.
authors.affiliation: Department of Orthopedic Surgery, Asahi General Hospital, 477 Tomari, Asahimachi, Toyama, 939-0741, Japan, nakato38@cosmo21.net.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakatoh
authors.forename: Yuki
authors.initials: Y
authors.lastname: Takemaru
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D058866:Osteoporotic Fractures / Q000175:diagnosis*; D018570:Risk Assessment
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