Recently people suspecting to have osteoporosis have a new simple method of diagnostics. A special tool allowing for detection of the disease is FRAX® algorithm which was developed by the World Health Organisation in collaboration with the Centre of Bone Metabolic Diseases, University of Sheffield (Great Britain). The algorithm is generally available on the Internet. An article which presents this tool also provides with broader introduction to its properties and directions for its use.

Osteoporosis is a disease in which the bone mass is reduced and it’s microarchitecture is reconstructed leading to an increased risk of fractures and consequently to pathologies which are dangerous for life. The disease is becoming a clinical problem increasingly. A prevalence of osteoporosis fractures is estimated to be 9 million per year worldwide. That is why accurate and early diagnostics is becoming more and more important in the context of saving human life and caring for health economics.

Until now osteoporosis diagnostics was based mainly on measuring the bone mineral density (BMD). By measuring BMD with densitometer one can state T-score. If it was lower than (-) 2,5 SD, the diagnosis of osteoporosis can be made.

FRAX® algorithm defines the feasibility of bone fracture occurrence in 10 years. It allows to suspect osteoporosis without a doctor’s intervention. Any user of the Internet can visit a site: www.shef.ac.uk/FRAX/ where he or she can anonymously answer 11 simple questions. They concern age, gender, body weight, height, bone fractures which occurred also in the family, smoking, taking glucocorticoids, rheumatoid arthritis, potation and secondary osteoporosis. The tool may increase its diagnostic power if one give the result of dual-energy X-ray absorptiometry.

A given data are calculated according to algorithms developed for particular countries in the world. They were developed on the basis of analysis of over 60 thousands men and women in Europe, North America, Asia and Australia. It is still developing on the basis of a new data.

FRAX® algorithm is a peculiar novelty in diagnostics. Whether it will be a standard depends on the acceptance of the medical profession and correlation of obtained results with clinical state of the patients. However, it constitute only the evaluation of fracture risks, specific diagnosis or exclusion of osteoporosis should be made by the doctor who can also evaluate other risk factors not included in the algorithm. Hopefully, due to the common availability of the tool the patients will be alerted to the possibility of osteoporosis occurrence and owing to this the rate of detecting the disease and its treatment will increase.

Author: Jerzy Bednarski

Source:
1. Johnell O.Kanis JA – An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoproos Int. 2006; 17:1726-1733
2.http://www.shef.ac.uk/FRAX/
3.Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Oglesby A. International variations in hip fracture probabilities: implications for risk assessment. Journal of Bone & Mineral Research 2002: 17; 1237-1244.
4.Kanis JA, on behalf of the World Health Organisation Scientific Group. Assessment of osteoporosis at the primary health care level. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield 2007