The online FRAX calculator that was used by the USPSTF is a “really good tool” for this purpose, she said. “Clinicians will have to access that tool in their clinics, which means they will either need Internet access at some point, or else they can download versions that are available for iPhone, or print versions”
Dr. Edward S. Leib also commended inclusion of the FRAX tool in the guidelines, but cautioned that it has some weaknesses that were discussed at a November 2010 “position development conference” conducted jointly by the International Osteoporosis Foundation and the International Society for Clinical Densitometry.
Some important risk factors that could affect the 10-year fracture risk would not necessarily be reflected in the FRAX calculation, he said. In addition, the FRAX tool is based on an international model, and although it included U.S. databases, the calculations may not reflect risks in regional populations.
Both Dr. Crandall and Dr. Leib also commended the USPSTF for acknowledging the need for more research in men, but Dr. Leib had hoped for more guidance. “It is known that the fracture risk in men who are age 75 is about equivalent to women who are age 65. I would have hoped that the USPSTF would have recommended screening at that age” despite the lack of primary prevention trials, he said.
DR. CRANDALL is professor of medicine at the University of California, Los Angeles. DR. LEIB is professor of medicine at the University of Vermont, Burlington. Hoth said hey have no pertinent conflicts of interest.