Abstract
Background
We sought to evaluate the concordance between self-assessed perceptions of fracture
risk and actual risk calculated by World Health Organization's 10-year Fracture Risk
Assessment Tool (FRAX).
Methods
We collected demographic data, lifestyle information, osteoporosis knowledge, bone
density test results, and treatment history from patients aged 50 to 75 years. Subjects
rated their perceptions of 10-year risk of sustaining fracture as low (0%–9%), intermediate
(10%–19%), or high (≥20%). This rating was compared with risk calculated by FRAX.
Findings
Among 426 patients, the greatest agreement regarding fracture risk was noted for those
in the low-risk FRAX group: 81% perceived themselves as having low risk. The most
risk disagreement was in the high-risk FRAX group: Only 18% perceived their risk as
high. Perceived risk was intermediate for 59% and low for 24%. Of patients at intermediate
calculated risk by FRAX, 48% agreed with this with self-perceived risk. Overall, risk
agreement was associated with bone density results, with higher T scores predictive
of agreement. Underestimation was associated with being female and older. Patients
with prescription treatment exposure frequently had risk disagreement and perceived
their risk as lower than their calculated FRAX scores might indicate. Patients taking
calcium and vitamin D similarly perceived lower risk than calculated by FRAX.
Conclusions
Patients at intermediate and high calculated fracture risk frequently had self-perceptions
of lower risk. Patients taking prescription osteoporosis medication and calcium and
vitamin D treatment perceived less risk than calculated. Whether correcting misperceptions
about personal susceptibility to fracture might result in behavioral changes will
be determined.
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Biography
Dr. Grover is an Assistant Professor of Family Medicine and a Research Scholar of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. His research interests include cost conscious care and guideline adherence.
Biography
Dr. Edwards is an Assistant Professor and Chairman of Family Medicine. He has research interests in assessing tools to improve physicians' clinical productivity and their communication with patients.
Biography
Dr. Chang is a Biostatistician and Research Associate in the Division of Biostatistics, Department of Health Services Research. She advises and collaborates with investigators in research protocol design as well as performing statistical analyses and assisting in manuscript preparation.
Biography
Dr. Cook is Professor of Medicine and Chair, Division of Endocrinology. An author of over 100 manuscripts, he actively mentors junior investigators while continuing an active research program which includes advancing inpatient diabetes management.
Biography
Dr. Behrens is an Assistant Professor of Family Medicine and holds a Certificate of Added Qualifications in Geriatric Medicine. She is active in the American Medical Directors Association and leads medical student educational activities for the Department.
Biography
Dr. Dueck is a Senior Associate Consultant and Assistant Professor of Biostatistics. She collaborates frequently with investigators in the Mayo Clinic Cancer Center while providing insights into study design, data analyses and manuscript preparation.
Article info
Publication history
Accepted:
November 19,
2013
Received in revised form:
November 15,
2013
Received:
February 1,
2013
Footnotes
Conflict of Interest: We have none to report, financial or otherwise.
Portions of this manuscript have been published in abstract form: Osteoporos Int 2011;22 (Suppl. 2):S421.
Identification
Copyright
© 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
