2 2.3 6.2 45–49 5.4 2.4 6.5 50–54 6.3 2.9 7.6 55–59 7.6 3.6 9.1 60–64 9.9 4.9 11.9 65–69 13.4 6.9 16.1 70–74 17.6 9.7 21.5 75–79 23.0 13.7 27.6 80–84 29.1 18.7 34.9 85–89 31.8 20.9 38.2 90–94 31.7 20.8 38.0 95–99 32.2 21.1 38.6 100+ 32.5 21.3 39.0 The lower assessment thresholds set by FRAX is based on the 10-year probability (in percent) of a major osteoporotic selleck fracture equivalent to women without clinical risk factors (a body mass index of 24 kg/m2 and without BMD). The upper assessment threshold is set at 1.2 times the intervention threshold. Population weighted mean

values for the five major EU countries Assessment thresholds for BMD testing The assessment strategy outlined in Fig. 4

requires the determination of assessment thresholds for making recommendations for the measurement https://www.selleckchem.com/products/epz-5676.html of BMD. There are, in principle, two assessment thresholds [89]: A threshold probability below which neither treatment nor a BMD test should be considered (lower assessment threshold) A threshold probability above which treatment may be recommended irrespective of BMD (upper assessment threshold) Most countries adopt a case finding strategy where individuals with clinical risk factors are identified for further assessment [8]. For this scenario, the lower assessment threshold can be set to exclude a requirement for BMD testing in women without clinical risk factors, as given in

previous European guidelines [1, 2, 102, 111]. check details The probability equivalents are given in Table 7. In a few countries, population-based assessment with BMD is recommended (Germany and France in Europe). In such cases, there would be no lower assessment threshold An upper threshold can be chosen to minimise the probability Glutathione peroxidase that a patient characterised to be at high risk on the basis of clinical risk factors alone would be reclassified to be at low risk with additional information on BMD [119]. In the UK, the upper assessment threshold was set at 1.2 times the intervention threshold [89]. The rationale is that reclassification of risk with the addition of a BMD test (from high risk to low risk and vice versa) is high when fracture probabilities estimated without BMD are close to the intervention threshold and the likelihood of reclassification decreases the further away the probability estimate is from the intervention threshold [119]. When patients have a fracture probability that is 20 % or more than the intervention threshold, almost no individuals will be reclassified (from high to low risk) when probabilities are recomputed with the addition of BMD to FRAX [119, 120, 123]. Thus, a quotient of 1.