A fracture risk profile using single-site bone density assessment and clinical risk factors

The Risk Factor Profile combines single-site bone density assessment and selected clinical risk factors to help estimate the risk of osteoporotic fracture for Caucasian postmenopausal women over the next 5 years. The bone density assessment uses T score cut-off values equivalent to the WHO definitions of osteoporosis and osteopenia at the hip that would identify 16-17% of women over 50 years of age as "high" risk. The clinical risk factors are defined as "major" producing about a doubling of fracture risk independent of bone density, and "minor" where the predictive power is less certain. The indications for a risk factor assessment using the Profile are the same as for any bone density assessment with the exception of monitoring response to treatment. In practice the clinical risk factors can be measured at the time of the bone density estimation taking only a few minutes. The decision to treat, or not to treat, a postmenopausal woman at high or medium risk will ultimately depend on the overall assessment of risks and benefits, costs of treatment and the desires of the patient. The Risk Factor Profile aims to supply the clinician with a simple tool to aid treatment decision-making.