Changes in treatment eligibility with race-neutral US FRAX would be modest: estimates using the National Health and Nutrition Examination Survey (NHANES)
Authors' conclusion
We found that changing US FRAX to a race-neutral calculator would only modestly increase treatment eligibility in US Black, Hispanic, and Asian people, while slightly decreasing eligibility in White people.
Study context
- Population
- Participants in NHANES 2013–2014 and 2005–2010, USA3,035 and 8458 participants
- Exposure
- Race-neutral FRAX vs current race-specific FRAX
- Outcome
- Change in osteoporosis treatment eligibility (thresholds 20% for MOF or 3% for hip fracture)
Methodological detailsNHANES 2013-2014 and 2005-2010, treatment thresholds 20% for major osteoporotic fracture (MOF) or 3% for hip fracture
- NHANES 2013-2014 and 2005-2010
- Treatment thresholds 20% for MOF or 3% for hip fracture
Main finding
As reported in the abstract
% eligible for treatment, race-specific → race-neutral FRAX, NHANES 2013-2014
- White women: decreased from 18.4 to 14.9%
- Black women: increased from 1.9 to 5.2%
- Hispanic women: increased from 3.9 to 7.0%
- Asian women: increased from 9.3 to 12.6%
- Changes in men were even smaller
Observational data: associations, not effects.
Original publication
Changes in treatment eligibility with race-neutral US FRAX would be modest: estimates using the National Health and Nutrition Examination Survey (NHANES). Osteoporos Int. Published 14 December 2025. doi:10.
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