title: A comparative study between the implementation of the FRIDEX calibration and the NOGG guideline in the management of osteoporosis in routine clinical practice.
abstract: OBJECTIVE
  The recent FRIDEX calibration proposed cost-effectiveness thresholds for the Spanish population. The aim of our study is to evaluate the impact of its application in routine clinical practice and to compare its thresholds with those of the National Osteoporosis Guideline Group (NOGG).
  
  
  METHODS
  Cross-sectional study in women referred to a bone densitometry unit who were not receiving antiresorptive therapy. The absolute risk of major fracture or hip fracture was calculated with the Spanish and British formulas of the FRAX®tool using the intervention thresholds of the FRIDEX calibration and the NOGG guideline, respectively.
  
  
  RESULTS
  The study included 607 women with a median age of 59.4 (IQR=14) years. Treatment was initiated in 31.4% after bone mineral densitometry. With the application of the FRIDEX calibration, bone mineral density testing would have been indicated in 35.4% of the sample and treatment in 26.7%, reducing costs by 18.8% over a 5-year period. The NOGG guideline would have recommended testing in 32% and treatment in 21.3% of the participants, resulting in a reduction in costs of 35% over 5years, when compared with the standard approach. Agreement between the FRIDEX calibration and the NOGG guideline, as defined by Cohen's kappa coefficient, was low in terms of both diagnostic (0.16 [95%CI, 0.09-0.24]) and therapeutic indications (0.39 [95%CI, 0.31-0.47]).
  
  
  CONCLUSIONS
  The application of the FRIDEX calibration and the NOGG guideline improves efficiency in the management of osteoporosis, although the level of agreement between the two is low.
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España; Departamento de Ciencias Biomédicas, Universidad de León, León, España. Electronic address: giorgos6@yahoo.com.
authors.forename: Georgios
authors.initials: G
authors.lastname: Kyriakos
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vidal-Casariego
authors.affiliation: Centro de Salud Jesús Marín, Molina de Segura, Murcia, España.
authors.forename: Lourdes Victoria
authors.initials: LV
authors.lastname: Quiles-Sánchez
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: Alicia
authors.initials: A
authors.lastname: Calleja-Fernández
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: Dalia
authors.initials: D
authors.lastname: Ávila-Turcios
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: Juan Andrés
authors.initials: JA
authors.lastname: Urosa-Maggi
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: María D
authors.initials: MD
authors.lastname: Ballesteros-Pomar
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Cano-Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000191:economics; D058866:Osteoporotic Fractures / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain
chemical_list: D050071:Bone Density Conservation Agents
keywords: FRAX(®); FRIDEX; NOGG; Osteoporosis