--- title: "Fracture risk tool validation in healthcare delivery system. | Sutter Health" description: "Fracture Risk Calculator tool, using administrative data, may help target at-risk populations for more complete fracture risk assessment." url: "https://www.sutterhealth.org/research/publications/fracture-risk-tool-validation-in-healthcare-delivery-system-1055312714" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Fracture risk tool validation in healthcare delivery system. # Fracture risk tool validation in an integrated healthcare delivery system. Lo JC, Pressman AR, Chandra M, & Ettinger B. _Am J Manag Care. 17(3):188-94._ 2011-03-01 ## Abstract OBJECTIVE: To evaluate the utility of the Fracture Risk Calculator (FRC, Foundation for Osteoporosis Research and Education) for predicting 10-year hip fracture risk within a "real world" population. STUDY DESIGN: Retrospective cohort study. METHODS: We identified female members of Kaiser Permanente Northern California aged ≥50 years with bone mineral density (BMD) measured during 1997-2003. Hospitalization for hip fracture was ascertained up to 10 years following the BMD date, and 10-year observed hip fracture probabilities were calculated. Baseline data for fracture risk calculation were extracted from health plan databases, including age, race/ethnicity, smoking, body mass index, prior fracture, rheumatoid arthritis, glucocorticoid use, disorders associated with bone loss, and femoral neck BMD. Predicted 10-year FRC hip fracture probabilities were compared with observed 10-year hip fracture probabilities. RESULTS: Among 94,489 women (mean age 62.8 +/- 8.6 years, average femoral neck Z-score +0.1),the median duration of follow-up was 6.6 years, during which 1579 (1.7%) hip fractures occurred. Using the FRC, 23% met or exceeded the National Osteoporosis Foundation's 3% hip fracture threshold. The FRC somewhat underestimated observed hip fracture probabilities; across 10-year risk categories <1%, 1% to 2.9%, and 3% to 4.9%, ratios of observed to median predicted probabilities ranged from 1.3 to 1.4. CONCLUSIONS: The FRC tool can be applied to assess fracture risk in large populations using data from administrative databases. Despite some underestimation, this relatively simple tool may assist targeting of at-risk populations for more complete fracture risk assessment. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/21504255/) ## Research topics - [Arthritis](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Arthritis%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Touchscreen questionnaire patient data collection in rheumatology practice: development of a highly successful system using process redesign.](https://www.sutterhealth.org/research/publications/touchscreen-questionnaire-to-collect-pt-data-in-rheumatology-1055312673) Newman ED, Lerch V, Jones JB, Stewart W. Arthritis Care Res (Hoboken). 64(4):589-96. doi: 10.1002/acr.21560. 2012 Apr 01 - Publication ### [Use of electronic health records for early detection of high-cost, low back pain patients.](https://www.sutterhealth.org/research/publications/use-ehrs-to-detect-high-cost-low-back-pain-pts-1055312584) Maeng DD, Stewart WF, Yan X, Boscarino JA, Mardekian J, Harnett J, Von Korff MR. Pain Res Manag. 20(5):234-40. Epub 2015 Aug 20. 2015 Sep 01 - Publication ### [The iceberg of health care utilization in women with urinary incontinence.](https://www.sutterhealth.org/research/publications/health-care-utilization-in-women-with-ui-is-low-1055312611) Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF. Int Urogynecol J. 23(8):1087-93. doi: 10.1007/s00192-012-1743-x. 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Epub 2015 Sep 19. 2016 Mar 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/fracture-risk-tool-validation-in-healthcare-delivery-system-1055312714#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Fracture risk tool validation in healthcare delivery system."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/fracture-risk-tool-validation-in-healthcare-delivery-system-1055312714#medicalscholarlyarticle","name":"Fracture risk tool validation in an integrated healthcare delivery system.","headline":"Fracture risk tool validation in healthcare delivery system.","abstract":"OBJECTIVE: To evaluate the utility of the Fracture Risk Calculator (FRC, Foundation for Osteoporosis Research and Education) for predicting 10-year hip fracture risk within a \"real world\" population. STUDY DESIGN: Retrospective cohort study. METHODS: We identified female members of Kaiser Permanente Northern California aged ≥50 years with bone mineral density (BMD) measured during 1997-2003. Hospitalization for hip fracture was ascertained up to 10 years following the BMD date, and 10-year observed hip fracture probabilities were calculated. Baseline data for fracture risk calculation were extracted from health plan databases, including age, race/ethnicity, smoking, body mass index, prior fracture, rheumatoid arthritis, glucocorticoid use, disorders associated with bone loss, and femoral neck BMD. Predicted 10-year FRC hip fracture probabilities were compared with observed 10-year hip fracture probabilities. RESULTS: Among 94,489 women (mean age 62.8 +/- 8.6 years, average femoral neck Z-score +0.1),the median duration of follow-up was 6.6 years, during which 1579 (1.7%) hip fractures occurred. Using the FRC, 23% met or exceeded the National Osteoporosis Foundation's 3% hip fracture threshold. The FRC somewhat underestimated observed hip fracture probabilities; across 10-year risk categories \u003c1%, 1% to 2.9%, and 3% to 4.9%, ratios of observed to median predicted probabilities ranged from 1.3 to 1.4. CONCLUSIONS: The FRC tool can be applied to assess fracture risk in large populations using data from administrative databases. 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