Introduction: Communication of absolute and relative risks is challenging despite the development of tools to quickly derive absolute fracture risk estimates from risk factors with or without BMD. We speculated that back-transformation of risks to a risk age could make for a clearer message and at the same time increase agreement between risk algorithms. Results: The algorithms differed less in estimated bone health age than in percent risk. A 60 years old woman with a maternal history of hip fracture has a predicted major osteoporotic fracture risk equivalent to that of a 71 years (FRAX) or 68 years-old woman (Qfracture). Treatment with 40% risk reduction is equivalent to a reduction in risk age by 10 years in both algorithms, reducing risk age to 62 (FRAX) or 60 years (Qfracture). Table 1 Assuming no treatment Assuming treatment with 40% risk reduction FRAX ‘Age’/ 10 years risk Qfracture ‘Age’/ 10 years risk FRAX ‘Age’/ 10 years risk Qfracture ‘Age’/ 10 years risk Age 60; maternal hip 71/12% 68/6.4% 62/7.2% 60/3.8% fx + own fracture 85/23% 77/10.7% 74/13.8% 69/6.4% Age 70; maternal hip 80/18% 80/12.3% 70/10.8% 70/7.4% fx + own fracture 90+/33% 82/13.3% 82/19.8% 72/8.0% Conclusions: Conversion of absolute fracture risk to equivalent bone health age is simple and intuitive and can accommodate both baseline BMD and the expected risk reductions on treatment.
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European Calcified Tissue Society conference, Lissabon 2013.