FRAX (Fracture Risk Assessment Tool) is a diagnostic tool used to evaluate the 10-year probability of

bone fracture A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a '' ...

risk. It was developed by the

University of Sheffield , mottoeng = To discover the causes of things , established = – University of SheffieldPredecessor institutions: – Sheffield Medical School – Firth College – Sheffield Technical School – University College of Sheffield , type = Pu ...

. FRAX integrates clinical risk factors and

bone mineral density Bone density, or bone mineral density, is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optica ...

at the

femoral neck The femoral neck (femur neck or neck of the femur) is a flattened pyramidal process of bone, connecting the femoral head with the femoral shaft, and forming with the latter a wide angle opening medialward. Structure The neck is flattened from ...

to calculate the 10-year probability of hip fracture and the 10-year probability of a major

osteoporotic Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone am ...

fracture (clinical spine, forearm, hip or shoulder fracture). The models used to develop the FRAX diagnostic tool were derived from studying patient populations in North America, Europe, Latin America, Asia and Australia.

Components

The parameters included in a FRAX assessment are: *Country *Age *Sex *Weight *Height *Previous fracture *Hip fracture in the subject's mother or father *

Smoking Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have bee ...

Glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebr ...

treatment *

Rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involv ...

*Disease strongly associated with osteoporosis *Alcohol intake of 3 or more

standard drink A standard drink is a measure of alcohol consumption representing a hypothetical beverage which contains a fixed amount of pure alcohol. A standard drink varies in volume depending on the alcohol concentration of the beverage (for example, a sta ...

s per day *

Bone mineral density Bone density, or bone mineral density, is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optica ...

(BMD) of the femoral neck *

Trabecular bone score The trabecular bone score is a measure of bone texture correlated with bone microarchitecture and a marker for the risk of osteoporosis. Introduced in 2008, its main projected use is alongside measures of bone density in better predicting fracture r ...

(optional)

Availability and usage

FRAX is freely accessible online, and commercially available as
desktop application
in paper-form as a FRAX Pad, as a
iPhone application
and as a
Android application
The tool is compatible with 58 models for 53 countries, and is available in 28 languages. FRAX is incorporated into many national guidelines around the world, including those of Belgium, Canada, Japan, Netherlands, Poland, Sweden, Switzerland, UK (NOGG), and US (NOF). FRAX assessments are intended to provide guidance for determining access to treatment in healthcare systems.

Adjustments

Glucocorticoid use is included FRAX as a

dichotomous A dichotomy is a partition of a whole (or a set) into two parts (subsets). In other words, this couple of parts must be * jointly exhaustive: everything must belong to one part or the other, and * mutually exclusive: nothing can belong simultan ...

variable, whereas the increased risk for fractures seen with glucocorticoid use is dependent on glucocorticoid dose and duration of use. Several methods have been proposed how to adjust FRAX accordingly. Though known to be a risk factor for fractures,

Type 2 Diabetes Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, ...

is not included as such in FRAX. Some clinicians choose rheumatoid arthritis as an equivalent risk factor instead. FRAX was developed and most commonly used to assess fracture risk for previously untreated individuals, though some have suggested is can also be used in those treated in the past or even on current treatment for osteoporosis.

References

External links

*{{Official website, http://www.shef.ac.uk/FRAX/
Alternate FRAX calculator that doesn't use Java
Medical diagnosis Medical terminology Nosology