The WHO Fracture Risk Assessment Tool - FRAX- has now been released as version 3.6 with new country models for Chile, Greece, Indonesia, Ireland and Lithuania. Downloadable charts for the newly added countries are also available.
Greek has been added as a language option, so that the calculator can now be utilized in 19 different languages.
FRAX is freely available online at http://www.shef.ac.uk/FRAX/ .
Launched by the World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK in 2008, FRAX- is a major milestone in helping health professionals improve the identification of patients at high risk of fracture. FRAX- assesses 10-year probability of fragility fracture in patients. It is country-specific and can be used with or without the input of Bone Mineral Density (BMD) values measured at the femoral neck.
Millions of individuals are assessed with FRAX- each year, and numbers continue to grow as the tool becomes integrated into an increasing number of country guidelines and becomes available in additional country models.
FRAX version 3.6 is now available for a total of 45 countries/territories in all regions of the world:
- Asia - China, Hong Kong, Indonesia, Taiwan, Japan, Singapore (3 models), Philippines, Sri Lanka (surrogate model), South Korea
- Europe - Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Lithuania, Malta, Netherlands, Norway, Poland, Romania, Russia, Slovakia, Spain, Sweden, Switzerland, Turkey and UK
- Middle East and Africa - Jordan, Lebanon, Tunisia
- North America - Canada, USA (4 models)
- Latin America - Argentina, Chile, Colombia, Ecuador, Mexico
- Oceania - Australia, New Zealand
Developing new national models
National models are derived from country-specific epidemiological data of the incidence of osteoporotic fractures and mortality rates. The minimum required data include the best available incidence data of hip fracture rates in the country, ideally from age 40 onwards and split into 5-year age bands. Incidence data on clinical spine, forearm, hip or shoulder fracture can also be included, where these are available. If the latter are unavailable, the relationship between hip fracture incidence and other major fractures is otherwise assumed to be similar to the relationship found in the Swedish population, for which there has been extensive research. The data is ideally country-wide; however, regional or centre-specific data may be used if this is representative enough of the country.
An estimated timeline of 6 months is necessary before the data goes through the development, checking and approval process.
FRAX- is accessible in various formats
In response to demand by physicians worldwide, a stand-alone version of FRAX that operates on a desktop or laptop computer without the need for internet access has been launched. FRAX-Desktop, developed in cooperation with the International Osteoporosis Foundation (IOF) and available at http://who-frax.org/index.php can be licensed in two different formats. The Individual-Entry version can be used to assess an unlimited number of individual patients in the clinic and the Multi-Patient Entry version is designed for researchers who need to analyse data from large cohorts in a single operation. FRAX has also been incorporated into several types of densitometers and is available as an application on the i-Phone and i-Pad obtainable at http://itunes.apple.com/us/app/frax/id370146412?mt=8 .
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