Use and Implications of the Fracture Risk Assessment Tool in Primary Hyperparathyroidism
Authors' conclusion
In this cohort study of US patients with PHPT, FRAX estimation exhibited acceptable performance.
Study context
- Population
- Adults aged 40 to 90 years with diagnosis or biochemistry findings consistent with primary hyperparathyroidism (PHPT), excluding those with missing or out-of-range FRAX parameters; US, 2000–2024
- Participants
- 59,194 adults
- Exposure
- PTX vs nonsurgical management
- PTXn = 14,783
- Outcome
- Observed major osteoporotic fracture (MOF) and hip fracture vs 10-year FRAX estimated probability (without bone mineral density (BMD))
Methodological detailsTriNetX electronic health record US dataset
- TriNetX electronic health record US dataset
Main finding
As reported in the abstract
FRAX calibration (observed vs estimated fracture)
Major osteoporotic fracture (MOF) calibration y-intercept
2.0%
MOF calibration slope
1.17
Hip fracture calibration y-intercept
1.4%
Hip fracture calibration slope
1.02
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MOF, overall12% decrease | 0.88 (0.77–1.02) | |
| Hip fracture, overall13% decrease | 0.87 (0.72–1.07) | |
| 0.512Hazard ratio (log scale) |
FRAX score thresholds above which PTX was associated with consistently lower fracture hazard
- MOF score threshold
- 1.2%
- Hip score threshold
- 2.7%
- Not meeting guideline-based surgical criteria but meeting hip score threshold
- 6522 (25.0%)
Original publication
Use and Implications of the Fracture Risk Assessment Tool in Primary Hyperparathyroidism. JAMA Netw Open. Published 2 March 2026. doi:10.
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