External validation of FRISBEE 2-year and 5-year fracture prediction models in a fracture liaison service cohort.
| Title: | External validation of FRISBEE 2-year and 5-year fracture prediction models in a fracture liaison service cohort. |
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| Authors: | Borgen TT; Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Postbox 800, N-3004, Drammen, Norway. tove.tveitan.borgen@vestreviken.no.; Brunborg C; Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.; Frihagen F; Department of Orthopedic Surgery, Østfold Hospital, Kalnes, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Solberg LB; Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.; Andreasen C; Department of Clinical Medicine, Uit, the Arctic University of Norway, Tromsø, Norway.; Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway.; Figved W; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Orthopedic Surgery, Vestre Viken Hospital Trust, Bærum Hospital, Gjettum, Norway.; Apalset EM; Bergen Group of Epidemiology and Biomarkers in Rheumatic Disease, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.; Gjertsen JE; Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Basso T; Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway.; Stutzer JM; Department of Orthopedic Surgery, Møre and Romsdal Hospital Trust, Molde Hospital, Molde, Norway.; Nordsletten L; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.; Eriksen EF; Faculty of Dentistry, University of Oslo, Oslo, Norway.; Pilestredet Park Specialist Centre, Oslo, Norway.; Bjørnerem Å; Department of Clinical Medicine, Uit, the Arctic University of Norway, Tromsø, Norway.; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway.; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway. |
| Source: | Archives of osteoporosis [Arch Osteoporos] 2025 Aug 02; Vol. 20 (1), pp. 107. Date of Electronic Publication: 2025 Aug 02. |
| Publication Type: | Journal Article; Validation Study |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: England NLM ID: 101318988 Publication Model: Electronic Cited Medium: Internet ISSN: 1862-3514 (Electronic) NLM ISO Abbreviation: Arch Osteoporos Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : Springer, [2006]- |
| MeSH Terms: | Osteoporotic Fractures*/epidemiology; Norway/epidemiology ; Risk Assessment/methods ; Bone Density/physiology ; Humans ; Female ; Aged ; Middle Aged ; Risk Factors ; Cohort Studies |
| Abstract: | We externally validated the FRISBEE models of 2-year and 5-year fracture risk prediction in 517 women with index fractures. Both models overestimated the fracture risk. Recalibration of the FRISBEE models are needed before use in Norwegian women with recent fractures.; Purpose: We externally validated the Fracture Risk Brussels Epidemiological Enquiry (FRISBEE) groups' 2-year and 5-year fracture risk models.; Methods: We included women above 50 years with a recent fracture from the consent-based part of the Norwegian Capture the Fracture Initiative study (NoFRACT). They had bone mineral density assessed and filled in a questionnaire including risk factors for fracture at baseline between October 2015 and December 2017. We calculated and validated the 2-year and 5-year fracture risk using the FRISBEE equation models.; Results: Of 517 women aged 65.5 ± 8.6 years with fractures, 94 (18%), 55 (11%), and 31 (6%) sustained a subsequent fracture of any type, major osteoporotic fractures (MOF), or central fracture, during 4.7 ± 1.3 years mean follow-up. The area under the receiver-operating curve (AUC) (95% confidence interval (CI)) for any type of fracture, MOF, and central fracture was 0.57 (0.51-0.63), 0.57 (0.46-0.67), and 0.65 (0.53-0.77), respectively, for the FRISBEE 2-year risk models and 0.57 (0.51-0.64), 0.58 (0.50-0.67), and 0.67 (0.57-0.76) for the FRISBEE 5-year risk models. The calibration slopes (with 95% CI) that compared observed vs. predicted probabilities for fracture across deciles of risk for any type of fracture, MOF, and central fracture were all low: 0.34 (0.02-0.64), 0.33 (- 0.09-0.74), and 0.61 (0.16-1.06), in the FRISBEE 2-year models, and 0.54 (0.13-0.95), 0.43 (0.05-0.80), and 0.69 (0.31-1.08), in the FRISBEE 5-year models.; Conclusion: Overall, the FRISBEE models overestimated both 2-year and 5-year fracture risk. Recalibration is needed before these models can be used in Norwegian women with recent fractures.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: Cathrine Brunborg, Camilla Andreasen, Ellen M. Apalset, Trude Basso, and Åshild Bjørnerem declare that they have no conflict of interest. Tove T. Borgen has received speaker’s fee from Amgen, UCB, Pharma Prim, and Roche Diagnostics. Frede Frihagen has received speaker fees from UCB and Amgen. Lene B. Solberg has received speaker’s fee from Eli Lilly, Amgen, and UCB. Wender Figved has received speaker fees from Ortomedic AS and Zimmer Biomet. Jan-Erik Gjertsen has received speaker fees from Ortomedic AS, Heraeus Medical, Smith and Nephew, and LINK Norway. Jens-Meinhard Stutzer has received speaker fees from BSN Medical. Lars Nordsletten has received speaker fees from Novartis, Eli Lilly, and Ortomedic AS. Erik F. Eriksen has received speaker fees from Novartis, Eli Lilly, Amgen, MSD, EffRx, IDS, and Shire. |
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| Grant Information: | 243852 Norges Forskningsråd; 14083 Helse Nord RHF; 1903007 Vestre Viken |
| Contributed Indexing: | Keywords: DXA; Fracture risk assessment; Osteoporosis |
| Entry Date(s): | Date Created: 20250801 Date Completed: 20250802 Latest Revision: 20251223 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12316711 |
| DOI: | 10.1007/s11657-025-01516-5 |
| PMID: | 40751006 |
| Database: | MEDLINE |
Journal Article; Validation Study