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Letters Predicted fracture risk

Confused thinking about discrepancies in predicted fracture risk in older people

BMJ 2013; 346 doi: (Published 12 March 2013) Cite this as: BMJ 2013;346:f1427
  1. Eugene McCloskey, professor of adult bone diseases and honorary consultant physician1,
  2. Juliet Compston, professor of bone medicine and honorary consultant physician2,
  3. John Kanis, emeritus professor3
  1. 1University of Sheffield, Metabolic Bone Centre, Northern General Hospital, Sheffield S5 7AU, UK
  2. 2University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
  3. 3University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX
  1. e.v.mccloskey{at}

Bolland and colleagues argue that estimates of fracture in older people should use a short time horizon of three to five years yet ignore competing mortality because it precludes effective treatment of these patients.1

They assume that adjustment for mortality risk in FRAX is based only on average mortality rates for the population, but the tool accommodates the fact that many risk …

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