Fracture risk scores using output from an opportunistic screen of low bone density from conventional X-ray
Authors' conclusion
In conclusion, FN T-Scores estimated by Rho from lumbar and thoracic X-rays add value to FRAX-NoT estimates and may be useful for risk assessment when DXA is not available.
Study context
- Population
- Canadian Multicentre Osteoporosis Study participants with lumbar and/or thoracic spine X-rays, FRAX risk factors and DXA T-Scores at the same time point, with fracture follow-up over 9 yrlumbar X-rays
- Participants
- 1,361 participants
- Exposure
- FRAX with Rho-estimated FN T-Score (FRAX-Rho) vs FRAX without T-Score (FRAX-NoT) vs FRAX with DXA FN T-Score (FRAX-DXA)
- Outcome
- Agreement with FRAX-DXA in categorizing by MOF risk (Cohen's weighted kappa)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
FRAX-Rho
0.80
Cohen's weighted kappa · CI 0.77–0.82
FRAX-NoT
0.76
Cohen's weighted kappa · CI 0.73–0.79
Observational data: associations, not effects.
Further findings
C-index
| Outcome | FRAX-Rho | FRAX-DXA | FRAX-NoT | P value |
|---|---|---|---|---|
| Discrimination for incident MOF (c-index) · 9 yrFRAX-Rho vs FRAX-DXA · did not differ | 0.76 | 0.77 | 0.73 | P = 0.36 |
| Discrimination for incident MOF (c-index) · 9 yrFRAX-Rho vs FRAX-NoT | P < 0.004 |
- Accuracy for predicting major osteoporotic fracture (MOF) (Brier Score) · FRAX-Rho vs FRAX-NoT · better with FRAX-Rho
- P < 0.05
- Discrimination for incident MOF (c-index): FRAX-Rho and FRAX-DXA both significantly greater than FRAX-NoT
Cohen's weighted kappa
FRAX-Rho
0.67(CI 0.63–0.71)
FRAX-NoT
0.52(CI 0.48–0.56)
- Agreement significantly greater for FRAX-Rho than FRAX-NoT
Accuracy for predicting MOF (Brier Score)
- FRAX-Rho accuracy not as good as FRAX-DXA
Thoracic X-rays
- Similar results in participants with thoracic X-rays
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Fracture risk scores using output from an opportunistic screen of low bone density from conventional X-ray. J Bone Miner Res. Published 19 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →