Background and Aim: Accurate and early identification of individuals at high risk for fractures is important for the prevention of fractures. Existing fracture risk calculators face difficulties in conveying the risk to users in an effective manner. In this context, we introduce an innovative bone health assessment and prevention digital tool called 'BONEcheck'.
Methods: The development of BONEcheck utilised data from multiple cohort studies. BONEcheck has 3 modules: input data, risk estimates, and risk context. Input variables include age, gender, prior fracture, fall incidence, bone mineral density (BMD), comorbidities, and genetic variants. By utilising published methodologies, BONEcheck generates output related to the probability of fracture and outcomes. BONEcheck also includes a module pertaining to fracture prevention. The vocabulary utilised to convey risk estimation and management is tailored to individuals with a reading proficiency at level 8 or above.
Results: The tool is designed for men and women aged 50 years and older who either have or have not sustained a fracture. Based on the input variables, BONEcheck estimates the probability of any fragility and hip fracture within 5 years, subsequent fracture, skeletal age, and the time to reach osteoporosis (T-score<-2.5). The probability of fracture is shown in both numeric and human icon array formats. The risk is also presented in the context of treatment and management options based on Australian guidelines. Skeletal age was estimated as the sum of chronological age and years of life lost due to a fracture or exposure to risk factors that elevate mortality risk.
Conclusions: BONEcheck is a new system of algorithms that aims to provide not only fracture risk probability but also contextualize the efficacy of anti-fracture measures concerning the survival benefits. The tool can enable doctors and patients to engage in well-informed discussions and make decisions based on the patient's risk profile.