Fracture Risk Assessment (FRAX) Tool: Difference between revisions

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== Objective ==
== Objective ==
FRAX is short for Fracture Risk Assessment. Clinicians use the FRAX calculator to predict the ten year probability of an osteoporosis fracture in a patient.
FRAX is short for Fracture Risk Assessment Tool. Clinicians use the FRAX calculator to predict the ten year probability of an osteoporosis fracture in a patient.


== Intended Population  ==
== Intended Population  ==
The FRAX calculator is used to to evaluate fracture risk of patients and can be used by a healthcare professional within their clinical decision making process to  know what intervention to best recommend. These interventions could incorporate pharmaceutical referral, an exercise program or nutritional changes.


== Method of Use  ==
== Method of Use  ==
To use the FRAX calculator, go to the [https://www.sheffield.ac.uk/FRAX/ FRAX website], Click on the dropdown "CALCULATION TOOL" in the top panel and select the continent and country.  
To use the FRAX calculator, go to the [https://www.sheffield.ac.uk/FRAX/ FRAX calculator]<ref>https://www.sheffield.ac.uk/FRAX/</ref> on the Sheffield University website,
 
Click on the dropdown "CALCULATION TOOL" in the top panel and select the continent and country.  


There are 2 components to the calculation
There are 2 components to the calculation
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== FRAX Score Interpretation ==
== FRAX Score Interpretation ==
Once you do the calculation, you will be given a red box score, and it has what the BMI is. It also lists the 10-year probability of a fracture.
After results have been calculated, you will see a "red box score". This shows the BMI and the 10-year probability of a fracture


Now that you have your FRAX score, how do you interpret the FRAX score to determine the weight bearing exercises in your MelioGuide Exercise for Better Bones program level?
In [https://melioguide.com/products/exercise-for-better-bones-program/ Exercise for Better Bones]<ref>https://melioguide.com/products/exercise-for-better-bones-program/</ref>, the cardiovascular (or weight bearing) exercise recommendations fall into three categories:
 
In [https://melioguide.com/products/exercise-for-better-bones-program/ Exercise for Better Bones], the cardiovascular (or weight bearing) exercise recommendations fall into three categories:
# Low Fracture Risk.
# Low Fracture Risk.
# Moderate Fracture Risk.
# Moderate Fracture Risk.
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== How to Adjust the T-Score Result ==
== How to Adjust the T-Score Result ==
The FRAX calculator is often based on specific populations in certain geographic areas. For example, if you use the calculator for the United States the results could be skewed to white females. If you are non-white, you may need to adjust (or normalize) your T Score and enter that adjusted score in the calculator.
The FRAX calculator is specific to populations and geographical locations. You may need to adjust your T-score for your patients particular demographic.


I have prepared a second video tutorial on how to do this. You will locate the adjustment tool online at the [http://courses.washington.edu/bonephys/opbmdtz.html following location]
After adjusting the T-score, use that figure in the FRAX calculator to continue and get your FRAX score.
 
[http://courses.washington.edu/bonephys/opbmdtz.html#convertTtoT Dr. Susan Ott’s website at the University of Washington], has created a video tutorial on how to convert the T-score to be more specific to your patient. The adjustment tool can be found online at the [http://courses.washington.edu/bonephys/opbmdtz.html University of Washington]<ref>http://courses.washington.edu/bonephys/opbmdtz.html</ref> website


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=== Normalize Your Score ===
* If you want to normalize the T-score, click on the [http://courses.washington.edu/bonephys/opbmdtz.html#convertTtoT Washington State University site].
* At the top, you’re going to see T and Z scores. Scroll down to “Convert T-scores for men and non-white races.”
** (Note that the website is a bit dated and the tool you will use is based on Adobe Flash. You might need to install this software into your browser to get the normalization tool to work.)
* Pay attention to the smaller box of the two boxes. In the smaller box, all the calculations that you see in the big box are done for you automatically. In the little box, choose the ethnicity and the sex that best describes your patient
* Convert by clicking on the convert arrow. You will receive the T-score that is most representative of a white-referenced female.
* That is a T-score.
* Bring that into your FRAX calculator tool. You place that in the box asking you for your T-score.
* Then complete your FRAX calculator to get your score.


== Limitations ==
== Limitations ==
# Medications are not considered. The FRAX calculator does not take into account the usage of medications that could affect bone health.
# Medications are not considered. The FRAX calculator does not take into account the usage of medications that could affect bone health.
# Calcium, Vitamin D, Vitamin K levels not considered
# Calcium, Vitamin D, Vitamin K levels not considered
== Reference  ==


== <span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span>Links  ==
== <span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span>Links  ==
https://www.sheffield.ac.uk/FRAX/index.aspx


== References  ==
== References  ==


<references />
<references />

Revision as of 20:14, 24 January 2021

Original Editor - User Name

Top Contributors - Carin Hunter and Kim Jackson  

Objective[edit | edit source]

FRAX is short for Fracture Risk Assessment Tool. Clinicians use the FRAX calculator to predict the ten year probability of an osteoporosis fracture in a patient.

Intended Population[edit | edit source]

The FRAX calculator is used to to evaluate fracture risk of patients and can be used by a healthcare professional within their clinical decision making process to know what intervention to best recommend. These interventions could incorporate pharmaceutical referral, an exercise program or nutritional changes.

Method of Use[edit | edit source]

To use the FRAX calculator, go to the FRAX calculator[1] on the Sheffield University website,

Click on the dropdown "CALCULATION TOOL" in the top panel and select the continent and country.

There are 2 components to the calculation

  1. The place you were born
  2. The place you currently live

The most accurate picture of bone health is to work out both scores and conduct a comparison. The initial calculation will give an idea of the genetic component while the second figure will incorporate information on your bone health related to sun exposure and diet.

The following information is then required

  • Age, date of birth, sex, weight and height
  • Previous and parent fracture history
  • Smoking status
  • Glucocorticoid steroid usage history
  • Rheumatoid arthritis
  • Secondary osteoporosis
  • Alcohol consumption
  • Femoral neck bone mineral density (BMD)

The results can then be calculated

FRAX Score Interpretation[edit | edit source]

After results have been calculated, you will see a "red box score". This shows the BMI and the 10-year probability of a fracture

In Exercise for Better Bones[2], the cardiovascular (or weight bearing) exercise recommendations fall into three categories:

  1. Low Fracture Risk.
  2. Moderate Fracture Risk.
  3. High Fracture Risk.

[3]

How to Adjust the T-Score Result[edit | edit source]

The FRAX calculator is specific to populations and geographical locations. You may need to adjust your T-score for your patients particular demographic.

After adjusting the T-score, use that figure in the FRAX calculator to continue and get your FRAX score.

Dr. Susan Ott’s website at the University of Washington, has created a video tutorial on how to convert the T-score to be more specific to your patient. The adjustment tool can be found online at the University of Washington[4] website

[3]

Limitations[edit | edit source]

  1. Medications are not considered. The FRAX calculator does not take into account the usage of medications that could affect bone health.
  2. Calcium, Vitamin D, Vitamin K levels not considered

Links[edit | edit source]

https://www.sheffield.ac.uk/FRAX/index.aspx

References[edit | edit source]

  1. ↑ https://www.sheffield.ac.uk/FRAX/
  2. ↑ https://melioguide.com/products/exercise-for-better-bones-program/
  3. ↑ 3.0 3.1 https://melioguide.com/frax/
  4. ↑ http://courses.washington.edu/bonephys/opbmdtz.html
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