High fracture probability with FRAX® usually indicates densitometric osteoporosis: Implications for clinical practice
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Summary: Most patients designated as high risk of fracture using fracture risk assessment tool ( FRAX® ) with femoral neck bone mineral density ( BMD ) ( i.e., 10-year major osteoporotic fracture probability exceeding 20% or hip fracture exceeding 3% ) have one or more T-scores in the osteoporotic range; conversely, almost no high risk patients have normal T-scores at all bone mineral density measurement sites. Introduction: We determined the agreement between a FRAX® designation of high risk of fracture [defined as 10-year major osteoporotic fracture probability ( ≥20% ) or hip fracture probability ( ≥3% )] and the WHO categorizations of bone mineral density according to T-score. Methods: Ten-year FRAX® probabilities calculated with femoral neck BMD were derived using both Canadian and US white tools for a large clinical cohort of 36,730 women and 2,873 men age 50 years and older from Manitoba, Canada. Individuals were classified according to FRAX fracture probability and BMD T-scores alone. Results: Most individuals designated by FRAX as high risk of major osteoporotic fracture had a T-score in the osteoporotic range at one or more BMD measurement sites ( 85% with Canadian tool and 83% with US white tool ). The majority of individuals deemed at high risk of hip fracture had one or more T-scores in the osteoporotic range ( 66% with Canadian tool and 64% with US white tool ). Conversely, there were extremely few individuals ( < 1% ) who were at high risk of major osteoporotic or hip fracture with normal T-scores at all BMD measurement sites. Conclusions: A FRAX designation of high risk of fracture is usually associated with a densitometric diagnosis of osteoporosis.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it