The Fracture Risk Assessment Tool (FRAX) and the Osteoporosis Self- Assessment Tool (OST) have suboptimal performance for predicting 10-year major osteoporotic fracture risk across racial/ethnic categories in younger postmenopausal women; however, the OST has excellent discrimination for identifying osteoporosis, according to a study published in JAMA Internal Medicine. Carolyn J. Crandall, MD, and colleagues analyzed data from 67,169 participants in the Women’s Health Initiative (baseline age range, 50-64) with 10 years of follow- up for major osteoporotic fracture (MOF; including hip, clinical spine, forearm, and shoulder fracture). For discrimination of MOF, area under the receiver operating characteristic curve values for FRAX were 0.65 for Asian, 0.55 for Black, 0.61 for Hispanic, and 0.59 for White women versus 0.62, 0.53, 0.58, and 0.55, respectively, for OST. However, for OST, discrimination of femoral neck osteoporosis was excellent (range, 0.79-0.85), with performance higher than FRAX (range, 0.72- 0.74) and similar for each racial and ethnic group.
