Advertisement

Archives of Osteoporosis

, 13:118 | Cite as

A brief history of FRAX

  • John A. KanisEmail author
  • Helena Johansson
  • Nicholas C. Harvey
  • Eugene V. McCloskey
Review Article

Abstract

Summary

This paper reviews the research programme that went into the development of FRAX® and its impact in the 10 years since its release in 2008.

Introduction

Osteoporosis is defined on the measurement of bone mineral density though the clinical consequence is fracture. The sensitivity of bone mineral density measurements for fracture prediction is low, leading to the development of FRAX to better calculate the likelihood of fracture and target anti-osteoporosis treatments.

Methods

The method used in this paper is literature review.

Results

FRAX, developed over an 8-year period, was launched in 2008. Since the launch of FRAX, models have been made available for 64 countries and in 31 languages covering more than 80% of the world population.

Conclusion

FRAX provides an advance in fracture risk assessment and a reference technology platform for future improvements in performance characteristics.

Keywords

FRAX Fracture probability Osteoporosis Fracture 

Notes

Compliance with ethical standards

Conflict of interests

All authors have contributed to the development of FRAX but have no financial interest.

References

  1. 1.
    Albright F, Bloomberg E, Smith P (1940) Post-menopausal osteoporosis. Trans Assoc Am Phys 55:298–305Google Scholar
  2. 2.
    Albright F, Smith P, Richardson A (1941) Postmenopausal osteoporosis: its clinical features. JAMA 116:2465–2474Google Scholar
  3. 3.
    Shapira D, Shapira C (1992) Osteoporosis: the evolution of a scientific term. Osteoporos Int 2:164–167Google Scholar
  4. 4.
    Wylie CD (2010) Setting a standard for a “silent” disease: defining osteoporosis in the 1980s and 1990s. Stud Hist Phil Biol Biomed Sci 41:376–385Google Scholar
  5. 5.
    Anonymous (1987) Consensus development conference: prophylaxis and treatment of osteoporosis. BMJ 295:914–915Google Scholar
  6. 6.
    Anonymous (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. JAMA 90:107–110Google Scholar
  7. 7.
    Anonymous (1993) Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 94:646–650Google Scholar
  8. 8.
    Anonymous (2000) Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 17:1–45Google Scholar
  9. 9.
    Siris ES, Adler R, Bilezikian J et al (2014) The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int 25:1439–1443PubMedPubMedCentralGoogle Scholar
  10. 10.
    Kanis JA, McCloskey EV, Harvey NC, Johansson H, Leslie WD (2015) Intervention thresholds and the diagnosis of osteoporosis. J Bone Miner Res 30:1747–1753PubMedGoogle Scholar
  11. 11.
    Nordin BEC (1987) The definition and diagnosis of osteoporosis. Calcif Tissue Int 40:57–58PubMedGoogle Scholar
  12. 12.
    Mazess RB (1987) Bone density in diagnosis of osteoporosis: thresholds and breakpoints. Calcif Tissue Int 41:117–118Google Scholar
  13. 13.
    Odvina CV, Wergedal JE, Libanati CR, Schultz EE, Baylink DJ (1988) Relationship between trabecular vertebral body density and fractures: a quantitative definition of spinal osteoporosis. Metabolism 37:221–228PubMedGoogle Scholar
  14. 14.
    National Osteoporosis Foundation (1989) Clinical indications for bone mass measurements. A report from the Scientific Advisory Board of the National Osteoporosis Foundation. J Bone Miner Res Suppl 2:1–28Google Scholar
  15. 15.
    Nelson HD, Helfand M (2002) Screening for postmenopausal osteoporosis. Rockville (MD): Agency for Healthcare Research and Quality (US); Available from http://wwwncbinlmnihgov/books/NBK42754/ accessed 28 Feb 2018
  16. 16.
    World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. report of a WHO study group WHO Technical Report Series, 843 Geneva: World Health Organization http://whqlibdocwhoint/trs/who_trs_843pdf accessed 23 June 2018
  17. 17.
    Kanis JA, Melton LJ III, Christiansen C et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedGoogle Scholar
  18. 18.
    Riggs LB, Melton LJ (eds) (1995) Osteoporosis: etiology, diagnosis, and management, 2nd edn. Lippincott-Raven Publishers, PhiladelphiaGoogle Scholar
  19. 19.
    World Health Organization (2003) Prevention and management of osteoporosis: report of a WHO scientific group. WHO Technical Report Series, 921. World Health Organization, Geneva http://whqlibdoc.who.int/trs/who_trs_921.pdf Google Scholar
  20. 20.
    Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590PubMedGoogle Scholar
  21. 21.
    Kanis JA, Johnell O, Oden A, Jonsson B, Dawson A, Dere W (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11:120–127PubMedGoogle Scholar
  22. 22.
    Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Prediction of fracture from low bone mineral density measurements overestimates risk. Bone 26:387–391PubMedGoogle Scholar
  23. 23.
    Odén A, Dawson A, Dere W, Johnell O, Jonsson B, Kanis JA (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8:599–603PubMedGoogle Scholar
  24. 24.
    Kanis JA, Johnell O, Odén A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674Google Scholar
  25. 25.
    Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B (2001) Ten-year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 12:989–995PubMedGoogle Scholar
  26. 26.
    Kanis JA, Johnell O, Oden A, De Laet C, Jonsson B, Dawson A (2002) Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30:251–258PubMedGoogle Scholar
  27. 27.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112PubMedGoogle Scholar
  28. 28.
    Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson B (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15:20–26Google Scholar
  29. 29.
    Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42PubMedGoogle Scholar
  30. 30.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473PubMedGoogle Scholar
  31. 31.
    Jonsson B, Kanis J, Dawson A, Oden A, Johnell O (1999) Effect and offset of effect of treatments for hip fracture on health outcomes. Osteoporos Int 10:193–199PubMedGoogle Scholar
  32. 32.
    Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244PubMedGoogle Scholar
  33. 33.
    Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427Google Scholar
  34. 34.
    Siggeirsdottir K, Aspelund T, Johansson H, Gudmundsson EF, Mogensen B, Jonsson BY et al (2014) The incidence of a first major osteoporotic fracture in Iceland and implications for FRAX. Osteoporos Int 25:2445–2451PubMedGoogle Scholar
  35. 35.
    Lam A, Leslie WD, Lix LM, Yogendran M, Morin SN, Majumdar SR (2014) Major osteoporotic to hip fracture ratios in Canadian men and women with Swedish comparisons: a population-based analysis. J Bone Miner Res 29:1067–1073PubMedGoogle Scholar
  36. 36.
    Hui SL, Slemenda CW, Johnston CC Jr (1988) Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 81:1804–1809PubMedPubMedCentralGoogle Scholar
  37. 37.
    Kanis JA, Black D, Cooper C, Dargent P, Dawson-Hughes B, De Laet C et al (2002) A new approach to the development of assessment guidelines for osteoporosis. Osteoporos Int 13:527–536PubMedGoogle Scholar
  38. 38.
    De Laet C, Odén A, Johansson H, Johnell O, Jönsson B, Kanis JA (2005) The impact of the use of multiple risk indicators for fracture on case-finding strategies: a mathematical approach. Osteoporos Int 16:313–318PubMedGoogle Scholar
  39. 39.
    Kanis JA, Borgstrom F, De Laet C, Johansson H, Johnell O, Jonsson B et al (2005) Assessment of fracture risk. Osteoporos Int 16:581–589PubMedGoogle Scholar
  40. 40.
    Johansson H, Oden A, Johnell O, Jonsson B, de Laet C, Oglesby A, McCloskey EV, Kayan K, Jalava T, Kanis JA (2004) Optimization of BMD measurements to identify high risk groups for treatment—a test analysis. J Bone Miner Res 19:906–913PubMedGoogle Scholar
  41. 41.
    Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001) Cost-effectiveness of preventing hip fracture in the general female population. Osteoporos Int 12:356–361PubMedGoogle Scholar
  42. 42.
    Zethraeus N, Ben Sedrine W, Caulin F, Corcaud S, Gathon HJ, Haim M, Johnell O, Jönsson B, Kanis JA, Tsouderos Y, Reginster JY (2002) Models for assessing the cost-effectiveness of the treatment and prevention of osteoporosis. Osteoporos Int 13:841–857PubMedGoogle Scholar
  43. 43.
    Kanis JA, Jonsson B (2002) Economic evaluation of interventions for osteoporosis. Osteoporos Int 13:765–767PubMedGoogle Scholar
  44. 44.
    Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jönsson B (2002) Intervention thresholds for osteoporosis. Bone 31:26–31PubMedGoogle Scholar
  45. 45.
    Zethraeus N, Borgström F, Ström O, Kanis JA, Jönsson B (2007) Cost-effectiveness of the treatment and prevention of osteoporosis—a review of the literature and a reference model. Osteoporos Int 18:9–23PubMedGoogle Scholar
  46. 46.
    De Laet C, Kanis JA, Oden A, Johansson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338PubMedGoogle Scholar
  47. 47.
    Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ III, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194Google Scholar
  48. 48.
    Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382PubMedGoogle Scholar
  49. 49.
    Kanis JA, Johansson H, Oden A, Johnell O, De Laet C, Eisman JA et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037PubMedGoogle Scholar
  50. 50.
    Kanis JA, Johnell O, Oden A, Johansson H, De Laet C, Eisman JA et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162PubMedGoogle Scholar
  51. 51.
    Kanis JA, Johansson H, Oden A, Johnell O, De Laet C, Melton LJ et al (2004) A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 19:893–899PubMedGoogle Scholar
  52. 52.
    Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA et al (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742PubMedGoogle Scholar
  53. 53.
    Kanis JA, on behalf of the World Health Organization Scientific Group (2008b) Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre, University of Sheffield, UK. https://www.sheffield.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf Accessed 12 May 2018
  54. 54.
    Kanis JA, Oden A, Johnell O (2001) Acute and long-term increase in fracture risk after hospitalisation for stroke. Stroke 32:702–706PubMedGoogle Scholar
  55. 55.
    Johnell O, Odén A, De Laet C, Garnero P, Delmas PD, Kanis JA (2002) Biochemical indices of bone turnover and the assessment of fracture probability. Osteoporos Int 13:523–526PubMedGoogle Scholar
  56. 56.
    Bagger YZ, Tanko LB, Alexandersen P, Hansen HB, Mollgaard A, Ravn P, Qvist P, Kanis JA, Christiansen C (2004) Two to three years of hormone replacement treatment in healthy women have long-term preventive effects on bone mass and osteoporotic fractures. The PERF study. Bone 34:728–735PubMedGoogle Scholar
  57. 57.
    Kanis JA, Johnell O, Oden A, De Laet C, de Terlizzi F (2005) Ten-year probability of clinical vertebral fractures according to phalangeal quantitative ultrasonography. Osteoporos Int 16:1065–1070PubMedGoogle Scholar
  58. 58.
    McCloskey EV, Johansson H, Kanis JA, Odén A, Harvey N, Bauer D, Hans D, Kaptoge S, Khaw KT, Krieg M-A, Kwok T, Marin F, Orwoll E, Reeve J, Glueer C (2015) Predictive ability of heel quantitative ultrasound for incident fractures: an individual-level meta-analysis. Osteoporos Int 26:1979–1987PubMedGoogle Scholar
  59. 59.
    Giangregorio LM, Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA (2012) FRAX underestimates fracture risk in patients with diabetes. J Bone Miner Res 27:301–308PubMedGoogle Scholar
  60. 60.
    McCloskey EV, Kanis JA, Odén A, Johansson H, Diez-Perez A, Eisman JA et al (2012) A meta-analysis of the association between falls and hip fracture risk. Osteoporos Int 23(Suppl 2):S80–S81Google Scholar
  61. 61.
    McClung MR, Geusens P, Miller PD et al (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340PubMedPubMedCentralGoogle Scholar
  62. 62.
    Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA et al (2005) A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16:799–804PubMedGoogle Scholar
  63. 63.
    Kanis JA, McCloskey E, Johansson H, Oden A, Leslie WD (2012) FRAX® with and without BMD. Calcif Tissue Int 90:1–13PubMedGoogle Scholar
  64. 64.
    Roux C, Reginster J-Y, Fechtenbaum J et al (2006) Vertebral fracture with reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors. J Bone Miner Res 21:536–542PubMedGoogle Scholar
  65. 65.
    Marcus R, Wang O, Satterwhite J et al (2003) The skeletal response to teriparatide is largely independent of age, initial bone mineral density and prevalent vertebral fractures in postmenopausal women with osteoporosis. J Bone Miner Res 18:18–23PubMedGoogle Scholar
  66. 66.
    Kanis JA, Barton I, Johnell O (2005) Risedronate decreases fracture risk in patients selected solely on the basis of prior vertebral fracture. Osteoporos Int 16:475–482PubMedGoogle Scholar
  67. 67.
    Kanis JA, Johnell O, Black DM et al (2003) Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women with osteopenia or osteoporosis: a reanalysis of the Multiple Outcomes of Raloxifene Evaluation trial. Bone 33:293–300PubMedGoogle Scholar
  68. 68.
    Johnell O, Kanis JA, Black DM et al (2004) Association between baseline risk factors and vertebral fracture risk in the Multiple Outcomes of Raloxifene Evaluation (MORE) study. J Bone Miner Res 19:764–772PubMedGoogle Scholar
  69. 69.
    McCloskey EV, Selby P, Davies M et al (2004) Clodronate reduces vertebral fracture risk in women with post-menopausal or secondary osteoporosis: results of a double-blind placebo-controlled 3-year study. J Bone Miner Res 19:728–736PubMedGoogle Scholar
  70. 70.
    Kanis JA, Johnell O, on behalf of the Committee of Scientific Advisors of the International Osteoporosis Foundation (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238PubMedGoogle Scholar
  71. 71.
    Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046PubMedGoogle Scholar
  72. 72.
    Borgström F, Johnell O, Kanis JA, Jönsson B, Rehnberg C (2006) At what hip fracture risk is it cost-effective to treat? International intervention thresholds for the treatment of osteoporosis. Osteoporos Int 17:1459–1471PubMedGoogle Scholar
  73. 73.
    Kanis JA, Johnell O, Oden A, Borgstrom F, Johansson H, De Laet C et al (2005) Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden. Osteoporos Int 16:6–14PubMedGoogle Scholar
  74. 74.
    Borgström F, Johnell O, Jönsson B, Zethraeus N, Sen SS (2004) Cost effectiveness of alendronate for the treatment of male osteoporosis in Sweden. Bone 34:1064–1071PubMedGoogle Scholar
  75. 75.
    Johnell O, Jönsson B, Jönsson L, Black D (2003) Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314PubMedGoogle Scholar
  76. 76.
    Borgström F, Carlsson A, Sintonen H, Boonen S, Haentjens P, Burge R, Johnell O, Jönsson B, Kanis JA (2006) The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective. Osteoporos Int 17:996–1007PubMedGoogle Scholar
  77. 77.
    Kanis JA, Borgstrom F, Johnell O, Jonsson B (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int 15:862–871PubMedGoogle Scholar
  78. 78.
    Kanis JA, Borgstrom F, Zethraeus N, Johnell O, Oden A, Jönsson B (2005) Intervention thresholds for osteoporosis in the UK. Bone 36:22–32PubMedGoogle Scholar
  79. 79.
    Borgström F, Johnell O, Kanis JA, Oden A, Sykes D, Jönsson B (2004) Cost effectiveness of raloxifene in the treatment of osteoporosis in Sweden: an economic evaluation based on the MORE study. Pharmacoeconomics 22:1153–1165PubMedGoogle Scholar
  80. 80.
    Zethraeus N, Borgström F, Jönsson B, Kanis J (2005) Reassessment of the cost-effectiveness of hormone replacement therapy in Sweden: results based on the Women’s Health Initiative randomized controlled trial. Int J Technol Assess Health Care 21:433–441PubMedGoogle Scholar
  81. 81.
    Borgström F, Jönsson B, Ström O, Kanis JA (2006) An economic evaluation of strontium ranelate in the treatment of osteoporosis in a Swedish setting: based on the results of the SOTI and TROPOS trials. Osteoporos Int 17:1781–1793PubMedGoogle Scholar
  82. 82.
    Ström O, Jönsson B, Kanis JA (2013) Intervention thresholds for denosumab in the UK using a FRAX®-based cost-effectiveness analysis. Osteoporos Int 24:1491–1502PubMedGoogle Scholar
  83. 83.
    Jönsson B, Ström O, Eisman JA, Papaioannou A, Siris ES, Tosteson A, Kanis JA (2011) Cost-effectiveness of denosumab for the treatment of postmenopausal osteoporosis. Osteoporos Int 22:967–982PubMedGoogle Scholar
  84. 84.
    Jönsson B, Ström O, Eisman JA, Papaioannou A, Siris ES, Tosteson A, Kanis JA (2012) Comment on: Cost-effectiveness of denosumab for the treatment of postmenopausal osteoporosis. Osteoporos Int 23:2063–2065PubMedGoogle Scholar
  85. 85.
    Zethraeus N, Ström O, Borgström F, Kanis JA, Jönsson B (2008) The cost-effectiveness of the treatment of high risk women with osteoporosis, hypertension and hyperlipidaemia in Sweden. Osteoporos Int 19:819–827PubMedGoogle Scholar
  86. 86.
    Tosteson AN, Melton LJ 3rd, Dawson-Hughes B, National Osteoporosis Foundation Guide Committee et al (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447PubMedPubMedCentralGoogle Scholar
  87. 87.
    Lippuner K, Johansson H, Kanis JA, Rizzoli R (2010) FRAX® assessment of osteoporotic fracture probability in Switzerland. Osteoporos Int 21:381–390PubMedGoogle Scholar
  88. 88.
    Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A, the National Osteoporosis Guideline Group (2008) Case finding for the management of osteoporosis with FRAX®—assessment and intervention thresholds for the UK. Osteoporos Int 19:1395–1408 Erratum 2009 Osteoporos Int 20, 499–502PubMedGoogle Scholar
  89. 89.
    Socialstyrelsen (2010) Nationella riktlinjer för rörelseorganens sjukdomar 2010 – stöd för styrning och ledning. Preliminär version. Artikelnr 2010-11-15. Published at www.socialstyrelsen.se
  90. 90.
    FORE; Foundation for Osteoporosis Research and Education (2012) The FORE 10-year fracture risk calculator https://riskcalculator.fore.org/default.aspx accessed 9 Sept 2017
  91. 91.
    Compston J, Cooper A, Cooper C, Francis R, Kanis JA, Marsh D, McCloskey EV, Reid DM, Selby P, Wilkins M, on behalf of the National Osteoporosis Guideline Group (NOGG) (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–108PubMedGoogle Scholar
  92. 92.
    National Osteoporosis Foundation (2008) Clinician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, D C, pp 1–36Google Scholar
  93. 93.
    Dawson-Hughes B, Looker AC, Tosteson ANA, Johansson H, Kanis JA, Melton LJ III (2010) The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int 21:41–52PubMedGoogle Scholar
  94. 94.
    Kanis JA, Adams J, Borgström F, Cooper C, Jönsson B, Preedy D et al (2008) The cost-effectiveness of alendronate in the management of osteoporosis. Bone 42:4–15PubMedGoogle Scholar
  95. 95.
    Royal College of Physicians (1999) Osteoporosis: clinical guidelines for the prevention and treatment. RCP, LondonGoogle Scholar
  96. 96.
    Kanis JA, Harvey NC, Cyrus Cooper C, Johansson H, Odén A, McCloskey EV et al (2016) A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11(1):25.  https://doi.org/10.1007/s11657-016-0278-z CrossRefPubMedPubMedCentralGoogle Scholar
  97. 97.
    Clark P, Lavielle P, Franco-Morina F, Ramirez E, Salmeron J, Kanis JA, Cummings SR (2005) Incidence rates and life-time risk of hip fractures in Mexicans over 50 years of age. A population-based study. Osteoporos Int 16:2025–2030PubMedGoogle Scholar
  98. 98.
    Lesnyak O, Ershova O, Belova K, Gladkova E, Sinitsina O, Ganert O, Marina Romanova M, Vitalij Khodirev V, Johansson H, McCloskey E, Kanis JA (2012) Epidemiology of fracture in the Russian Federation and the development of a FRAX model. Arch Osteoporos 7:67–73.  https://doi.org/10.1007/s11657-012-0082-3 CrossRefPubMedGoogle Scholar
  99. 99.
    Lesnyak O, Sahakyan S, Zakroyeva A, Bilezikian JP, Hutchings N, Galstyan R et al (2017) Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its designated surrogate country. Arch Osteoporos 12:98.  https://doi.org/10.1007/s11657-017-0392-6 CrossRefPubMedPubMedCentralGoogle Scholar
  100. 100.
    Ramanau H, Chernyanin I, Rudenka E, Lesnyak O, Zakroyeva A, Bilezikian JP, Johansson H, Harvey NC, McCloskey E, Kanis JA (2018) Epidemiology of hip fracture in Belarus: development of a country-specific FRAX model and its comparison to neighbouring countries. Arch Osteoporos 13(1):42.  https://doi.org/10.1007/s11657-018-0454-4 CrossRefPubMedPubMedCentralGoogle Scholar
  101. 101.
    Ettinger B, Black D, Dawson-Hughes B, Pressman AR, Melton LJ III (2009) Updated fracture incidence rates for the US version of FRAX®. Osteoporos Int 21:25–33PubMedPubMedCentralGoogle Scholar
  102. 102.
    Tuzun S, Eskiyurt N, Akarırmak U, Sarıdoğan M, Senocak M, Johansson H et al (2012) Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 23:949–955PubMedGoogle Scholar
  103. 103.
    Odén A, McCloskey EV, Kanis JA, Harvey NC, Johansson H (2015) Burden of high fracture probability worldwide: secular increases 2010-2040. Osteoporos Int 26:2243–2248PubMedGoogle Scholar
  104. 104.
    Clark P, Denova-Gutierrez E, Zerbini C, Sanchez A, Messina O, Jaller JJ, Campusano C, González J, Riera G, Johansson H, Kanis JA (2017) FRAX-based intervention and assessment thresholds in seven Latin American countries. Osteoporos Int 29:707–715PubMedGoogle Scholar
  105. 105.
    Johansson H, Kanis JA, McCloskey EV, Odén A, Devogelaer J-P, Kaufman J-M, Neuprez A, Hiliigsmann M, Bruyere O, Reginster JY (2011) A FRAX® model for the assessment of fracture probability in Belgium. Osteoporos Int 22:453–461PubMedGoogle Scholar
  106. 106.
    Silva DMW, Borba VZC, Kanis JA (2017) Building FRAX Brazil: clinical risk factors and applicability of this tool in Joinville, Southern Brazil. Arch Osteoporos 9;12(1):111. doi:  https://doi.org/10.1007/s11657-017-0405-5
  107. 107.
    Zerbini CAF, Szejnfeld VL, Abergaria BH, McCloskey EV, Johansson H, Kanis JA (2015) Incidence of hip fracture in Brazil and the development of a FRAX model. Arch Osteoporos 10(1):224.  https://doi.org/10.1007/s11657-015-0224-5 CrossRefPubMedGoogle Scholar
  108. 108.
    Leslie WD, Lix LM, Langsetmo L, Berger C, Goltzman D, Hanley DA, Adachi JD, Johansson H, Oden A, McCloskey EV, Kanis JA (2011) Construction of a FRAX® model for the assessment of fracture probability in Canada and implications for treatment. Osteoporos Int 22:817–827PubMedGoogle Scholar
  109. 109.
    Stepan JJ, Vaculik J, Pavelka K, Zofka J, Johansson H, Kanis JA (2012) Hip fracture incidence between years 1981 and 2009 in the Czech Republic as a basis of the country-specific FRAX model. Calcif Tissue Int 90:365–372PubMedGoogle Scholar
  110. 110.
    Jaller-Raad JJ, Jaller-Char JJ, Lechuga-Ortiz JA, Navarro-Lechuga E, Johansson H, Kanis JA (2013) Incidence of hip fracture in Barranquilla, Colombia and the development of a Colombian FRAX model. Calcif Tissue Int 93:15–22PubMedGoogle Scholar
  111. 111.
    Sund R, Honkanen R, Johansson H, Oden A, McCloskey EV, Kanis JA, Kröger H (2014) Evaluation of the FRAX model for the prediction of hip fractures in Kuopio, Finland. Calcif Tissue Int 95:39–45PubMedGoogle Scholar
  112. 112.
    Tsang SWY, Kung AWC, Kanis JA, Johansson H, Oden A (2009) Ten-year fracture probability in Hong Kong southern Chinese according to age and BMD femoral neck T-scores. Osteoporos Int 20:1939–1945PubMedGoogle Scholar
  113. 113.
    McGowan B, Kanis JA, Johansson H, Silke C, Whelan B (2013) Development and use of FRAX in the management of osteoporosis in Ireland. Arch Osteoporos 8(1–2):146.  https://doi.org/10.1007/s11657-013-0146-z CrossRefPubMedGoogle Scholar
  114. 114.
    Piscitelli P, Brandi ML, Chitano G, Johannson H, Kanis JA, Black DM (2013) Updated fracture incidence rates for the Italian version of FRAX®. Osteoporos Int 24:859–866PubMedGoogle Scholar
  115. 115.
    Fujiwara S, Nakamura T, Orimo H, Hosoi T, Gorai I, Oden A, Johansson H, Kanis JA (2008) Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAX™). Osteoporos International 19:429–448Google Scholar
  116. 116.
    Johansson H, Azizieh F, Harvey NC, McCloskey E, Kanis JA (2017) FRAX- vs. T-score-based intervention thresholds for osteoporosis. Osteoporos Int 28:3099–3105PubMedPubMedCentralGoogle Scholar
  117. 117.
    Lalmohamed A, Welsing PMJ, Lems WF, Jacobs JWG, Kanis JA, Johansson H, De Boer A, De Vries F (2012) Calibration of FRAX ® 3.1 to the Dutch population with data on the epidemiology of hip fractures. Osteoporos Int 23:861–869PubMedGoogle Scholar
  118. 118.
    Czerwiński E, Kanis JA, Osieleniec J, Kumorek A, Milert A, Johansson H et al (2011) Evaluation of FRAX to characterize fracture risk in Poland. Osteoporos Int 22:2507–2512PubMedGoogle Scholar
  119. 119.
    Marques A, Mota A, Canhão H, Romeu JC, Machado P, Ruano A et al (2013) A FRAX® model for the estimation of osteoporotic fracture probability in Portugal. Acta Reumatol Port 38:104–112PubMedGoogle Scholar
  120. 120.
    Grigorie D, Sucaliuc A, Johansson H, Kanis JA, McCloskey E (2013) Incidence of hip fracture in Romania and the development of a Romanian FRAX model. Calcif Tissue Int 92:429–436PubMedGoogle Scholar
  121. 121.
    Johansson H, Kanis JA, Lunggren O, Ström O, Svensson O, Mellström D (2011) FRAX – model för att beräkna 10-årsrisken för fraktur. [FRAX—model for 10-year fracture risk assessment. Support in the treatment of osteoporosis, according to preliminary Swedish guidelines]. Läkartidningen 108:336–339PubMedGoogle Scholar
  122. 122.
    Lippuner K, Johansson H, Rizzoli R, Kanis JA (2009) Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. Osteoporos Int 20:1131–1140PubMedGoogle Scholar
  123. 123.
    Tuzun S, Eskiyurt N, Akarırmak U, Sarıdoğan M, Johansson H, Kanis JA, the Turkish Osteoporosis Society (2012) The impact of FRAX-based intervention thresholds in Turkey: the FRAX-TURK study. Arch Osteoporos 7:229–235PubMedGoogle Scholar
  124. 124.
    Povoroznyuk VV, Grygorieva NV, Kanis JA, McCloskey EV, Johansson H, Harvey NC, Korzh MO, Strafun SS, Vaida VM, Klymovytsky FV, Vlasenko RO, Forosenko VS (2017) Epidemiology of hip fracture and the development of FRAX in Ukraine. Arch Osteoporos 12(1):53.  https://doi.org/10.1007/s11657-017-0343-2 CrossRefPubMedPubMedCentralGoogle Scholar
  125. 125.
    Looker AC, Dawson-Hughes B, Tosteson ANA, Johansson H, Kanis JA, Melton LJ III (2010) Hip fracture risk in older US adults by treatment eligibility status based on new National Osteoporosis Foundation guidance. Osteoporos Int 22:541–549PubMedGoogle Scholar
  126. 126.
    Committee for Medicinal Products for Human Use (CHMP) (2006) Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. London: CHMP; Ref CPMP/EWP/552/95Rev.2Google Scholar
  127. 127.
    Kanis JA, Jönsson B, Odén A, McCloskey EV (2011) A meta-analysis of the effect of strontium ranelate on the risk of vertebral and non-vertebral fracture in postmenopausal osteoporosis and the interaction with FRAX®. Osteoporos Int. 22: 2347-2355 with erratum. Osteoporos Int 22:2357–2358Google Scholar
  128. 128.
    Kanis JA, Johansson H, Oden A, McCloskey EV (2009) Bazedoxifene reduces vertebral and clinical fractures in postmenopausal women at high risk assessed with FRAX®. Bone 44:1049–1054PubMedGoogle Scholar
  129. 129.
    Kanis JA, Johansson H, Oden A, McCloskey EV (2010) A meta-analysis of the efficacy of raloxifene on all clinical and vertebral fractures and its dependency on FRAX®. Bone 47:729–735PubMedGoogle Scholar
  130. 130.
    McCloskey EV, Johansson H, Oden A, Vasireddy S, Kayan K, Pande K et al (2009) Ten-year fracture probability identifies women who will benefit from clodronate therapy—additional results from a double-blind, placebo-controlled randomised study. Osteoporos Int 20:811–817PubMedGoogle Scholar
  131. 131.
    Harvey NC, Kanis JA, Odén A, Burge RT, Mitlak BH, Johansson H, McCloskey EV (2015) FRAX and the effect of teriparatide on vertebral and non-vertebral fracture. Osteoporos Int 26:2347–2353PubMedPubMedCentralGoogle Scholar
  132. 132.
    Harvey NC, Kanis JA, Odén A, Nakamura T, Shiraki M, Sugimoto T, Kuroda T, Johansson H, McCloskey EV (2015) Efficacy of weekly teriparatide does not vary by baseline fracture probability calculated using FRAX. Osteoporos Int 26:2347–2354PubMedPubMedCentralGoogle Scholar
  133. 133.
    McCloskey EV, Johansson H, Oden A, Harvey NC, Jiang H, Modin S et al (2017) The effect of abaloparatide-SC on fracture risk is independent of baseline FRAX fracture probability: a post hoc analysis of the ACTIVE study. J Bone Miner Res 32:1625–1631PubMedPubMedCentralGoogle Scholar
  134. 134.
    McCloskey EV, Johansson H, Oden A, Austin M, Siris E, Wang A et al (2012b) Denosumab reduces the risk of all osteoporotic fractures in postmenopausal women, particularly in those with moderate to high fracture risk as assessed with FRAX®. J Bone Miner Res 27:1480–1486PubMedGoogle Scholar
  135. 135.
    Donaldson MG, Palermo L, Ensrud KE, Hochberg MC, Schousboe JT, Cummings SR (2012) Effect of alendronate for reducing fracture by FRAX score and femoral neck bone mineral density: the Fracture Intervention Trial. J Bone Miner Res 27:1804–1810PubMedGoogle Scholar
  136. 136.
    Shepstone L, Lenaghan E, Cooper C et al (2018) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet 391(10122):741–747Google Scholar
  137. 137.
    McCloskey E, Shepstone L, Lenaghan E, Cooper C, Clarke S, Fong R et al (2018) Management of patients with high baseline hip fracture risk by FRAX reduces hip fractures—a post hoc analysis from the SCOOP study. J Bone Miner Res 33:1020–1026PubMedPubMedCentralGoogle Scholar
  138. 138.
    Ström O, Borgström F, Kleman M et al (2010) FRAX and its applications in health economics—cost-effectiveness and intervention thresholds using bazedoxifene in a Swedish setting as an example. Bone 47:430–437PubMedGoogle Scholar
  139. 139.
    National Institute for Health and Care Excellence (2017) TA464: bisphosphonates for treating osteoporosis. Technology appraisal guidance 464. National Institute for Health and Care Excellence, London nice.org.uk/guidance/ta464 Google Scholar
  140. 140.
    Ström O, Borgström F, Kanis JA, Jönsson B (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20:23–34 Erratum in: Osteoporos Int 20: 35PubMedGoogle Scholar
  141. 141.
    Borgström F, Jonsson E, Harvey N et al (2018) Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting. Osteoporos Int WCO abstract in pressGoogle Scholar
  142. 142.
    Turner DA, Khioe RFS, Shepstone L, Lenaghan E, Cooper C, Gittoes N et al (2018) The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. J Bone Miner Res 33:845–851PubMedPubMedCentralGoogle Scholar
  143. 143.
    Kanis JA, Hans D, Cooper C et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:2395–2411PubMedGoogle Scholar
  144. 144.
    Johansson H, Odén A, McCloskey EV, Kanis JA (2014) Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int 25:235–241PubMedGoogle Scholar
  145. 145.
    Van Staa TP, Leufkens HG, Abenhaim L, Zhang B, Cooper C (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15:993–1000PubMedGoogle Scholar
  146. 146.
    Hans DB, Kanis JA, Baim S et al (2011) Joint official positions of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. Executive summary of the 2010 position development conference on interpretation and use of FRAX® in clinical practice. J Clin Densitom 14:171–180PubMedGoogle Scholar
  147. 147.
    Kanis JA, Johansson H, Oden A, McCloskey EV (2011) Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int 22:809–816PubMedGoogle Scholar
  148. 148.
    Johansson H, Kanis JA, Odén A et al (2014) Impact of femoral neck and lumbar spine BMD discordances on FRAX probabilities in women: a meta-analysis of international cohorts. Calcif Tissue Int 95:428–435PubMedPubMedCentralGoogle Scholar
  149. 149.
    Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA (2011) Spine-hip discordance and fracture risk assessment: a physician-friendly FRAX enhancement. Osteoporos Int 22:839–847PubMedGoogle Scholar
  150. 150.
    Leslie WD, Johansson H, Kanis JA et al (2014) Lumbar spine texture enhances 10-year fracture probability assessment. Osteoporos Int 25:2271–2277PubMedGoogle Scholar
  151. 151.
    Leslie WD, Shevroja E, Johansson H et al (2018) Risk-equivalent T-score adjustment using lumbar spine trabecular bone score (TBS): the Manitoba BMD Registry. Osteoporos Int 29:751–758PubMedPubMedCentralGoogle Scholar
  152. 152.
    McCloskey EV, Oden A, Harvey NC et al (2015) Adjusting fracture probability by trabecular bone score. Calcif Tissue Int 96:500–509PubMedGoogle Scholar
  153. 153.
    McCloskey EV, Odén A, Harvey NC et al (2016) A meta-analysis of trabecular bone score in fracture risk prediction and its dependence on FRAX. J Bone Miner Res 31:940–948PubMedGoogle Scholar
  154. 154.
    Leslie WD, Lix LM, Morin SN et al (2015) Adjusting hip fracture probability in men and women using hip axis length: the Manitoba Bone Density Database. J Clin Densitom 19:326–331PubMedGoogle Scholar
  155. 155.
    Masud T, Binkley N, Boonen S, Hannan MT, on behalf of the FRAX Position Conference members (2011) Can falls and frailty be used in FRAX? J Clin Densitom 14:194–204PubMedGoogle Scholar
  156. 156.
    Johansson H, Odén A, Lorentzon M et al (2015) Is the Swedish FRAX model appropriate for immigrants to Sweden? Osteoporos Int 26:2617–2622PubMedGoogle Scholar
  157. 157.
    Leslie WD, Rubin MR, Schwartz AZ, Kanis JA (2012) Perspective: diabetes and bone. J Bone Miner Res 27:2231–2237PubMedGoogle Scholar
  158. 158.
    Leslie WD, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D (2018) Comparison of methods for improving fracture risk assessment in diabetes: the Manitoba BMD Registry. J Bone Miner Res, Submitted Feb 2018Google Scholar
  159. 159.
    Hippisley-Cox J, Coupland C (2009) Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractures scores. BMJ 339:b4229PubMedPubMedCentralGoogle Scholar
  160. 160.
    Chen P, Krege JH, Adachi JD et al (2009) Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. J Bone Miner Res 24:495–502PubMedPubMedCentralGoogle Scholar
  161. 161.
    Ensrud KE, Lui LY, Taylor BC et al (2009) A comparison of prediction models for fractures in older women: is more better? Arch Int Med 169:2087–2094Google Scholar
  162. 162.
    Donaldson MG, Palermo L, Schousboe JT, Ensrud KE, Hochberg MC, Cummings SR (2009) FRAX and risk of vertebral fractures: the fracture intervention trial. J Bone Miner Res 24:1793–1799PubMedGoogle Scholar
  163. 163.
    Sornay-Rendu E, Munoz F, Delmas PD, Chapurlat RD (2010) The FRAX® tool in French women: how well does it describe the real incidence of fracture in the OFELY cohort. J Bone Miner Res 25:2101–2107PubMedGoogle Scholar
  164. 164.
    Pluskiewicz W, Adamczyk P, Franek E et al (2010) Ten-year probability of osteoporotic fracture in 2012 Polish women assessed by FRAX and nomogram by Nguyen et al.—conformity between methods and their clinical utility. Bone 46:1661–1667PubMedGoogle Scholar
  165. 165.
    Sandhu SK, Nguyen ND, Center JR, Pocock NA, Eisman JA, Nguyen TV (2010) Prognosis of fracture: evaluation of predictive accuracy of the FRAX™ algorithm and Garvan nomogram. Osteoporos Int 21:863–871PubMedGoogle Scholar
  166. 166.
    Tremollieres FA, Pouilles JM, Drewniak N, Laparra J, Ribot CA, Dargent-Molina P (2010) Fracture risk prediction using BMD and clinical risk factors in early postmenopausal women: sensitivity of the WHO FRAX tool. J Bone Miner Res 25:1002–1009PubMedPubMedCentralGoogle Scholar
  167. 167.
    Bolland MJ, Siu AT, Mason BH et al (2011) Evaluation of the FRAX and Garvan fracture risk calculators in older women. J Bone Miner Res 26:420–427PubMedGoogle Scholar
  168. 168.
    Hillier TA, Cauley JA, Rizzo JH (2011) The WHO absolute fracture risk models (FRAX): do clinical risk factors improve fracture prediction in older women without osteoporosis? J Bone Miner Res 26:1774–1782PubMedPubMedCentralGoogle Scholar
  169. 169.
    Tamaki J, Iki M, Kadowaki E, Sato Y et al (2011) The clinical utility of FRAX to discriminate fracture status in men and women with chronic kidney disease. Osteoporos Int 25:71–76Google Scholar
  170. 170.
    Azagra R, Roca G, Encabo G et al (2012) FRAX® tool, the WHO algorithm to predict osteoporotic fractures: the first analysis of its discriminative and predictive ability in the Spanish FRIDEX cohort. BMC Musculoskelet Disord 13:204.  https://doi.org/10.1186/1471-2474-13-204 CrossRefPubMedPubMedCentralGoogle Scholar
  171. 171.
    Leslie WD, Lix LM (2014) Comparison between various fracture risk assessment tools. Osteoporos Int 25:1–21PubMedGoogle Scholar
  172. 172.
    National Clinical Guideline Centre (2012) Osteoporosis: fragility fracture risk. Osteoporosis: assessing the risk of fragility fracture. Short clinical guideline—CG146 evidence and recommendations’ August 2012. Published by the National Clinical Guideline Centre by the Royal College of Physicians, LondonGoogle Scholar
  173. 173.
    Kanis JA, Oden A, Johansson H, McCloskey E (2012) Pitfalls in the external validation of FRAX. Osteoporos Int 23:423–431PubMedGoogle Scholar
  174. 174.
    Marques A, Ferreira RJO, Santos E, Loza E, Carmona L, Pereira da Silva JA (2015) The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis 74:1958–1967PubMedGoogle Scholar
  175. 175.
    Nayak S, Edwards DL, Saleh AA, Greenspan SL (2015) Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density. Osteoporos Int 26:1543–1554PubMedPubMedCentralGoogle Scholar
  176. 176.
    Järvinen TL, Jokihaara J, Guy P, Alonso-Coello P, Collins GS, Michaëlsson K, Sievänen H (2014) Conflicts at the heart of the FRAX tool. CMAJ 186:165–167PubMedPubMedCentralGoogle Scholar
  177. 177.
    Järvinen TL, Michaëlsson K, Aspenberg P, Sievänen H (2015) Osteoporosis: the emperor has no clothes. J Int Med 277:662–673Google Scholar
  178. 178.
    Järvinen TL, Michaëlsson K, Jokihaara J, Collins GS, Perry TL, Mintzes B, Musini V, Erviti J, Gorricho J, Wright JM, Sievänen H (2015) Overdiagnosis of bone fragility in the quest to prevent hip fracture. BMJ 350:h2088.  https://doi.org/10.1136/bmj.h2088 CrossRefPubMedGoogle Scholar
  179. 179.
    Compston JE, Cooper A, Cooper C et al (2008) Drugs for pre-osteoporosis: an example of prejudice-based medicine? BMJ 336:126.  https://doi.org/10.1136/bmj.39435.656250.AD CrossRefGoogle Scholar
  180. 180.
    Compston J (2015) Overdiagnosis of osteoporosis: fact or fallacy? Osteoporos Int 26:2051PubMedGoogle Scholar
  181. 181.
    Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, Hope S, Kanis JA, McCloskey EV, Poole KES, Reid DM, Selby P, Thompson F, Thurston A, Vine N, The National Osteoporosis Guideline Group (NOGG) (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43.  https://doi.org/10.1007/s11657-017-0324-5 CrossRefPubMedPubMedCentralGoogle Scholar
  182. 182.
    Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster J-Y, on behalf of the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF) (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24:23–57Google Scholar
  183. 183.
    Javaid K (2015) Overdiagnosis of bone fragility in the quest to prevent hip fracture. BMJ 350:h2088.  https://doi.org/10.1136/bmj.h2088 CrossRefGoogle Scholar
  184. 184.
    Ford N, Norris SL, Hill SR (2016) Clarifying WHO’s position on the FRAX® tool for fracture prediction. Bull World Health Organ 94:862PubMedPubMedCentralGoogle Scholar
  185. 185.
    Gollogly L, Susan Norris S, Ford N (2018) Correcting the record on a fracture risk assessment tool. N Engl J Med 378:867–868PubMedGoogle Scholar
  186. 186.
    Kanis JA (2000) Proposal for renewal of designation as a WHO collaborating Centre. University of Sheffield https://www.sheffield.ac.uk/FRAX/pdfs/WHO_2000.pdf accessed 5 may 2018
  187. 187.
    World Health Organization (2007) WHO scientific group on the assessment of osteoporosis at primary health care level. Summary Meeting Report Brussels, Belgium, 5–7 May 2004 http://www.who.int/chp/topics/Osteoporosis.pdf?ua=1 Accessed 4 Mar 2018
  188. 188.
    Kanis JA, the WHO study group (1994) Assessment of fracture risk and its application to postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 4:368–381PubMedGoogle Scholar
  189. 189.
    Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475Google Scholar
  190. 190.
    Anonymous (2005) WHO statement on hormonal contraception and bone health. Wkly Epidemiol Rec 80:302–304Google Scholar
  191. 191.
    Retraction Watch (2017) WHO asks dozens of journals to correct papers on diagnostic tool developed by former collaborators. https://retractionwatch.com/2017/11/16/asks-dozens-journals-correct-papers-diagnostic-tool-developed-former-collaborators/ accessed 19th November 2017
  192. 192.
    Brown T (2016) In defence of evidence, expertise, and facts. BMJ 355:i6467PubMedGoogle Scholar
  193. 193.
    National Institute for Health and Care Excellence (2012) NICE clinical guideline 146. Osteoporosis: assessing the risk of fragility fracture. London, UK. https://www.nice.org.uk/guidance/cg146, Accessed 18 Jan 2017

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • John A. Kanis
    • 1
    • 2
    Email author
  • Helena Johansson
    • 2
  • Nicholas C. Harvey
    • 3
    • 4
  • Eugene V. McCloskey
    • 1
    • 5
  1. 1.Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  2. 2.Mary McKillop Research InstituteAustralian Catholic UniversityMelbourneAustralia
  3. 3.MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
  4. 4.NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
  5. 5.Mellanby Centre for Bone Research, Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK

Personalised recommendations