Selection for treatment of patients at high risk of fracture by the short versus long term prediction models — data from the Belgian FRISBEE cohort
Authors' conclusion
In our Belgian FRISBEE cohort, the imminent model was less sensitive but more selective in the selection of subjects in whom an imminent fracture should be prevented, resulting in a lower NNT. The correction for recency in this elderly population further decreased the selectivity of FRAX®.
Study context
- Population
- Subjects of the Belgian FRISBEE cohort who sustained an incident MOF (mean age 76.5 ± 6.8 years)480 incident, 54 imminent MOFs
- Comparison
- FRISBEE imminent model vs FRAX, before and after adjustment for recency
- Outcome
- Selection for treatment of patients at high risk of imminent MOF (within 2 years): sensitivity and specificity of each model
- Follow-up
- 2 years
Methodological detailscohort (FRISBEE), Follow-up 6.8 years
- Cohort (FRISBEE)
- Follow-up 6.8 years
Performance
As reported in the abstract
Imminent MOF: sensitivity and specificity
| Test or model | Sensitivity (risk >20%) | Sensitivity | Specificity |
|---|---|---|---|
| FRAX | 94.0% | — not stated in the abstract | 20.2% |
| FRAX adjusted for recency | 98.1% | — not stated in the abstract | 5.9% |
| FRISBEE model | — not stated in the abstract | 72.2% | 55.4% |
Sensitivity (risk >20%)
FRAX94.0%
FRAX adjusted for recency98.1%
FRISBEE model— not stated in the abstract
Sensitivity
FRAX— not stated in the abstract
FRAX adjusted for recency— not stated in the abstract
FRISBEE model72.2%
Specificity
FRAX20.2%
FRAX adjusted for recency5.9%
FRISBEE model55.4%
— not stated in the abstract
Further findings
Patients identified at high risk by both models (before correction) and their imminent MOF · 2 years
- Identified at high risk in both models
- 47.3%
- Of these, had an imminent MOF
- 17.2%
- Adjustment for recency did not change this selection
Patients selected for treatment by FRAX only · 2 years
- Selected by FRAX only, before correction
- 34.2%
- Of these, imminent MOF, before correction
- 18.8%
- Selected by FRAX only, after adjustment for recency
- 47%
- Of these, MOF within 2 years, after adjustment
- 6%
NNT with the imminent model
- Decrease in NNT with the new model
- 30%
Original publication
Selection for treatment of patients at high risk of fracture by the short versus long term prediction models — data from the Belgian FRISBEE cohort. Osteoporos Int. Published 6 April 2023. doi:10.
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