Letter to the Editor regarding "The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report"

Authors: DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; COSMAN, FELICIA - Columbia University - New York; MCCLUNG, MICHAEL - Oregon Osteoporosis Center

Submitted to: Journal of Bone and Mineral Research
Publication Type: Other
Publication Acceptance Date: 7/8/2024
Publication Date: 7/22/2024
Citation: Dawson-Hughes, B., Cosman, F., Mcclung, M. 2024. Letter to the Editor regarding "The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report". Journal of Bone and Mineral Research. https://doi.org/10.1093/jbmr/zjae107.
DOI: https://doi.org/10.1093/jbmr/zjae107

Interpretive Summary:

Technical Abstract: In a recent issue of the Journal of Bone and Mineral Research, The American Society for Bone and Mineral Research Task Force Report recommends that race/ethnicity be removed as a variable in the widely used calculator of fracture risk (FRAX). Currently the calculator contains race because fracture rates vary widely by race and this has a strong effect on risk of future fracture. The proposed rationale for the change is that non-White women have worse outcomes when they fracture, compared with White women. Treating more low-risk patients is not the solution to the myriad factors resulting in poorer health outcomes among non-White persons. Additionally, the absolute benefit of osteoporosis treatment is very modest in low-risk patients. There is no question that more robust fracture incidence data for non-White persons in the US and race/ethnicity-specific risk factor effect sizes would be very useful. Obtaining such evidence, rather than arbitrarily altering risk predictors, should be the objective of all of us interested in providing more accurate - and equitable - fracture risk prediction for our patients.