{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T02:46:37Z","timestamp":1793501197158,"version":"4.5.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T00:00:00Z","timestamp":1711152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST110-2314-B-006-054-MY2"],"award-info":[{"award-number":["MOST110-2314-B-006-054-MY2"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["NSTC112-2314-B-006-023-MY3"],"award-info":[{"award-number":["NSTC112-2314-B-006-023-MY3"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The Fracture Risk Assessment Tool (FRAX\u00ae) is a widely utilized country-specific calculator for identifying individuals with high fracture risk; its score is calculated from 12 variables, but its formulation is not publicly disclosed. We aimed to decompose and simplify the FRAX\u00ae by utilizing a nationwide community survey database as a reference module for creating a local assessment tool for osteoporotic fracture community screening in any country. Participants (n\u2009=\u200916384; predominantly women (75%); mean age\u2009=\u200964.8\u00a0years) were enrolled from the Taiwan OsteoPorosis Survey, a nationwide cross-sectional community survey collected from 2008 to 2011. We identified 11 clinical risk factors from the health questionnaires. BMD was assessed via dual-energy X-ray absorptiometry in a mobile DXA vehicle, and 10-year fracture risk scores, including major osteoporotic fracture (MOF) and hip fracture (HF) risk scores, were calculated using the FRAX\u00ae. The mean femoral neck BMD was 0.7\u2009\u00b1\u20090.1\u00a0g\/cm2, the T-score was \u22121.9\u2009\u00b1\u20091.2, the MOF was 8.9\u2009\u00b1\u20097.1%, and the HF was 3.2\u2009\u00b1\u20094.7%. Following FRAX\u00ae decomposition with multiple linear regression, the adjusted R2 values were 0.9206 for MOF and 0.9376 for HF when BMD was included and 0.9538 for MOF and 0.9554 for HF when BMD was excluded. The FRAX\u00ae demonstrated better prediction for women and younger individuals than for men and elderly individuals after sex and age stratification analysis. Excluding femoral neck BMD, age, sex, and previous fractures emerged as 3 primary clinical risk factors for simplified FRAX\u00ae according to the decision tree analysis in this study population. The adjusted R2 values for the simplified country-specific FRAX\u00ae incorporating 3 premier clinical risk factors were 0.8210 for MOF and 0.8528 for HF. After decomposition, the newly simplified module provides a straightforward formulation for estimating 10-year fracture risk, even without femoral neck BMD, making it suitable for community or clinical osteoporotic fracture risk screening.<\/jats:p>","DOI":"10.1093\/jbmrpl\/ziae039","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T15:22:52Z","timestamp":1711207372000},"source":"Crossref","is-referenced-by-count":4,"title":["Decomposing and simplifying the Fracture Risk Assessment Tool\u2014a module from the Taiwan-specific calculator"],"prefix":"10.1093","volume":"8","author":[{"given":"Chia-Chun","family":"Li","sequence":"first","affiliation":[{"name":"Institute of Allied Health Sciences , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"},{"name":"Department of Family Medicine , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Ting","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, E-DA Hospital , 824 Kaohsiung , Taiwan"},{"name":"Department of Geriatric Medicine, E-DA Hospital , 824 Kaohsiung , Taiwan"},{"name":"School of Medicine , College of Medicine, , 840 Kaohsiung , Taiwan"},{"name":"I-Shou University , College of Medicine, , 840 Kaohsiung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien-Tsai","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Rheumatology , Allergy and Immunology, , 833 Kaohsiung , Taiwan"},{"name":"Kaohsiung Chang Gung Memorial Hospital , Allergy and Immunology, , 833 Kaohsiung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Wen","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Public Health , College of Health Sciences, , 807 Kaohsiung , Taiwan"},{"name":"Kaohsiung Medical University , College of Health Sciences, , 807 Kaohsiung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zih-Jie","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, National Cheng Kung University Hospital Dou Liu Branch , 640 Yunlin , Taiwan"},{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , 704 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin-Fan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , 704 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Sung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , 704 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ching","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"},{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , 704 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsueh","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Public Health , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chieh","family":"Kuo","sequence":"additional","affiliation":[{"name":"Institute of Allied Health Sciences , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"},{"name":"Department of Occupational Therapy , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0504-2053","authenticated-orcid":false,"given":"Chih-Hsing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"},{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , 704 Tainan , Taiwan"},{"name":"Institute of Gerontology , College of Medicine, , 701 Tainan , Taiwan"},{"name":"National Cheng Kung University , College of Medicine, , 701 Tainan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,23]]},"reference":[{"issue":"S02","key":"2024042100243103100_ref1","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1007\/s00198-004-1702-6","article-title":"Epidemiology of osteoporotic fractures","volume":"16","author":"Johnell","year":"2005","journal-title":"Osteoporos Int"},{"key":"2024042100243103100_ref2","volume-title":"WHO Scientific Group on the assessment of osteoporosis at primary health care level","author":"World Health Organization","year":"2007"},{"issue":"5","key":"2024042100243103100_ref3","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.18632\/aging.203927","article-title":"The association between osteoporosis medications and lowered 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