External validation of a novel HR-pQCT based fracture risk assessment tool (μFRAC) in a male cohort: the osteoporotic fractures in men (MrOS) study
Authors' conclusion
The $\mu $FRAC models demonstrated strong performance and generalizability to an external cohort of older men.
Study context
- Population
- Older community-dwelling men aged ≥77 years in the United States (MrOS cohort)
- Participants
- 1,586 men
- Comparison
- μFRAC vs FRAX and FN aBMD alone
- Outcome
- Discrimination (AUC) and calibration of μFRAC risk estimates for major osteoporotic fracture
- Follow-up
- 5-year risk
Methodological detailsmulticentre cohort, competing risk regression (calibration), ROC/AUC (discrimination), Incident fracture information collected every 4 months
- Multicentre cohort
- Competing risk regression (calibration)
- ROC/AUC (discrimination)
- Incident fracture information collected every 4 months
Performance
As reported in the abstract
5-year MOF risk discrimination · 5 years
| Test or model | AUC |
|---|---|
| μFRAC | 0.685-0.703 |
| FRAX | 0.641 |
| FN aBMD | 0.636 |
AUC
μFRAC0.685-0.703
FRAX0.641
FN aBMD0.636
- Calibration of μFRAC 5-year risk estimates in MrOS (regression slope)
- 0.8-1.1
Further findings
| Outcome | $\mu $FRAC |
|---|---|
| 5-year risk discrimination in subgroup classified as moderate risk by FRAX (10%-20% MOF risk) | |
| AUC | 0.691-0.706 |
- Calibration of $\mu $FRAC 5-year risk estimates (regression slope)
- 0.8-1.1
Calibration of $\mu $FRAC 5-year risk estimates (regression slope)
- Good generalizability of 5-year risk estimates to MrOS cohort
5-year risk discrimination in subgroup classified as moderate risk by FRAX (10%-20% major osteoporotic fracture (MOF) risk)
- $\mu $FRAC aided in stratifying risk, particularly for 5-year risk estimates
Original publication
External validation of a novel HR-pQCT based fracture risk assessment tool (μFRAC) in a male cohort: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res. Published 31 December 2025. doi:10.
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