Whenever I go on a ride, I'm always thinking of what's wrong with the thing and how it can be improved.
-Walt Disney Every day you may make progress. Every step may be fruitful. Yet there will stretch out before you an ever-lengthening, ever-ascending, ever-improving path. You know you will never get to the end of the journey.
-Winston Churchill Time is a dressmaker specializing in alterations.
-Faith Baldwin F RAX will be 3 years old on February 21, 2011. It has grown and matured through several iterations, currently Version 3.2, with most recent changes (at the time of this writing) made on December 8, 2010. It has been adapted for use in 30 countries and is accessible in 14 languages (www.shef.ac.uk/FRAX/).
FRAX uses clinical risk factors (age, sex, body mass index [BMI], prior fragility fracture, a parental history of hip fracture, smoking, excess alcohol intake, use of systemic corticosteroids, rheumatoid arthritis, and secondary osteoporosis) and expected mortality to estimate an individual's 10-year risk of hip fracture and major osteoporosis-related fracture. If bone mineral density (BMD) is not available, FRAX can be used with BMI to estimate fracture risk. (1) Since FRAX was introduced, critics have claimed that it does not include enough risk factors. For example, low calcium intake, vitamin D deficiency, fall risk, and high bone turnover markers are not considered. (2) Countering those critics are studies showing that more parsimonious models (ie, using only BMD and age or BMD, age, and fracture) appear to perform as well as FRAX.
(3) A simplified approach may work efficiently in populations where other risk factors occur uncommonly. However, circumstances may dictate the need for the more comprehensive information contained in FRAX (eg, rheumatoid arthritis and glucocorticoids in a rheumatology practice), and some specialties may find that important risk factors are not included in FRAX