Table 6.
Tool specific external validation of original tools: discriminatory measures* of QFracture, FRAX, and Garvan when evaluated in populations of the same age ranges as the original tools. Values in parentheses are nominators/denominators
| Tools | Hip fractures | Major osteoporotic fractures | |||||
|---|---|---|---|---|---|---|---|
| Overall | Men | Women | Overall | Men | Women | ||
| QFracture—30-100 years: | |||||||
| AUC (%) | 88.0 | 85.6 | 88.6 | 75.4 | 68.6 | 77.4 | |
| Sensitivity† (%) | 61.4 (19 471.1/31 709) | 59.9 (6294.8/10 517) | 58.3 (12 362.9/21 192) | 35.7 (35 379.2/99 058) | 31.4 (10 129.5/32 209) | 32.7 (21 849.5/66 849) | |
| Specificity† (%) | 90.9 (1 694 534.1/1 864 704) | 90.6 (794 409.8/876 852) | 91.0 (899310.8/987852) | 91.4 (1 643 093.2/1 797 355) | 90.8 (776 552.4/855 160) | 91.6 (863 140.4/942 195) | |
| FRAX—50-90 years: | |||||||
| AUC (%) | 81.5 | 79.6 | 81.5 | 71.4 | 68.4 | 69.8 | |
| Sensitivity† (%) | 43.6 (12 257.4/28 091) | 42.7 (3836.8/8996) | 41.3 (7894.3/19 095) | 29.0 (23 628.9/81 564) | 28.0 (6521.5/23 268) | 25.3 (14 770.3/58 296) | |
| Specificity† (%) | 90.9 (933 500.3/1 026 724) | 90.6 (425 782.8/469 829) | 91.1 (507 190.2/556 895) | 91.6 (891 398.9/973 251) | 90.9 (414 195.5/455 557) | 91.7 (474 865.3/517 694) | |
| Garvan—60-95 years‡: | |||||||
| AUC (%) | 71.2 | 76.5 | 75.7 | ||||
| Sensitivity† (%) | 28.7 (8013.7/27 897) | 35.6 (3050.1/8571) | 33.1 (6392.3/19 326) | ||||
| Specificity† (%) | 90.8 (583 508.7/642 538) | 90.8 (259 335.0/285 713) | 91.2 (325 602.3/356 825) | ||||
AUC=area under receiver operating characteristic curve (C statistic).
*Assessed with five years of follow-up and calculated for cut-off of top 10% risk for each tool.
†Numerator case numbers contain a decimal component because they are averaged between imputed datasets.
‡Analyses comparing performance for predicting major osteoporotic fractures were only conducted between QFracture and FRAX because Garvan’s definition for major osteoporotic fractures is much broader than those for QFracture and FRAX.