Differing Risk scores: I put my data... - Bone Health and O...

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Differing Risk scores

Fruitandnutcase profile image
5 Replies

I put my data into the Sheffield FRAX tool we got from Met00 the other day and the results are quite different (and better) compared to the ones I got from my hospital.

My hospital has the estimated 10 year risk for a major osteoporotic fracture at 33% and a hip fracture at 10%.

The Sheffield one has estimated my risk at Major as 19% and hip fracture as 5.9%

Anyone got any idea why this is?

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Fruitandnutcase profile image
Fruitandnutcase
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5 Replies
Met00 profile image
Met00

How strange. The hospital should have used FRAX. I wonder if they put in any risk factors that aren't relevant to you?

Fruitandnutcase profile image
Fruitandnutcase in reply to Met00

Woops! Sorry you’re right, my results don’t - they list Site BMD (g/cm2) T score Z score plus everything else you need for the FRX result. My hospital risk for major osteoporotic fracture works out at 33% and for hip 10%I was thinking Z was FRAX which it isn’t. Where does FRAX come in or am I clutching at straws and the lower FRAX just as poor as the hospital result ?

Met00 profile image
Met00 in reply to Fruitandnutcase

T-scores compare your bone density with an average 30 year old, when we reach peak bone mass, giving an estimate of how much density you've lost since then. Z-scores compare your density with average for your age, so because we all start losing bone density from about age 40, z-scores are always going to be better than t-scores. Although loss of bone density is linked with loss of bone strength, it isn't a clearcut link. For example, you and I may have the same bone density yet your bones may be stronger than mine. That's where FRAX comes in, as it tries to take into account a range of other factors that can affect fracture risk. It's still only an estimate and is more accurate for a large group of people than one individual. Again an example: if 100 people have a FRAX score that says they're at 10% risk of a hip fracture in the next 10 years, that means 10 of them will fracture their hips in the next 10 years, but 90 won't. That has been shown to be quite accurate. What it doesn't tell you is which 10 people will fracture. Statistically each individual is more likely to be amongst the 90 who don't fracture, but of course for the 10 who do, they're individual risk might as well be 100%!

Whether you consider your fracture risk to be poor or not depends on how you view risk. A 33% risk of a major osteoporotic fracture still means 67 people in a group of 100 won't fracture (but of course 33 will). It is quite a high fracture risk, but I'd be interested to know what factors have contributed to this score? What are your t-scores? Have you had any fragility fractures already? Are you on any medication that raises your risk? Do you have any digestive issues that reduce absorption? Do you smoke or drink a lot of alcohol? I'm not asking you to answer all these questions, as I realise they're very personal, but it may be that there are contributory factors that you can do something about in order to reduce the risk.

wellness1 profile image
wellness1

You've mentioned your wrist fracture -- the result could vary depending on whether it was entered as an osteoporotic fracture or not. Could that account for the difference?

Fruitandnutcase profile image
Fruitandnutcase in reply to wellness1

Not sure, as you can see above FRAX and the hospital results are obviously quite different - hopefully Met00 can explain.

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