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Decisions to initiate bisphosphonate therapy are uncontroversial for patients who are obviously at high risk (e.g., older women with unequivocal osteoporosis on bone-density testing or people who have already experienced fractures). But for lower-risk patients, such decisions often are made arbitrarily, according to a clinician’s intuition about the relative importance of various risk factors.
To help standardize our approach to prevention and treatment of osteoporosis, a new paradigm called “FRAX” was introduced by the World Health Organization in 2008. The new model was built on results from large observational studies on clinical risk factors for fractures. Clinicians can enter patient-specific information into an online calculator that d…