Osteoarthrology
The role of 10-year probability of bone fracture risk with FRAX tool in qualification for diagnosis of osteoporosis. Results of POMOST study

The aim of the study was to evaluate the role of the FRAX tool in qualification of patients for diagnostic procedures before the decision on pharmacological treatment and to verify our previous decisions based on the qualitative method used in the National Centre of Osteoporosis (KCO). The study was performed in 952 subjects (825 females and 127 males) aged 63.5±9.7 years not treated due to osteoporosis who were referred to our centre during 1 year for diagnosis of osteoporosis and qualification for pharmacological treatment. The analysis was done using the FRAX tool with clinical fracture risk factors, among others BMI (FRAX-BMI), and separately with a qualitative method. Absolute 10-year fracture risk (RB-10) >11% for women (population risk) and >8% for men (the lower border of the medium risk) were considered as the indication for diagnostic procedures. The values of RB-10 were 9.1±6.1% (2.3-54%) for women, and 5.6±2.5% (2.4-20%) for men. Values of RB-10 which qualify for diagnosis were found in 246 subjects (25.8%), 231 women (28%) and 15 men (11.8%). Five hundred and twenty-six subjects (55.3%), 461 women (55.9%) and 65 men (51.2%), were qualified for diagnosis on the basis of the qualitative method. We conclude that a high percentage of the patients were referred to the specialist centre without any important indication according to the qualitative method and especially the FRAX-BMI tool. The qualitative method can be used parallel with the FRAX-BMI tool in subjects with low and high 10-year fracture risk. There is a need to popularize the proper procedures in osteoporosis.