Frequently Asked Questions

Users Question & Answer:


    The development of BONEcheck is described in the following preprint:

    Nguyen D, et al. BONEcheck: a digital tool for personalized bone health assessment.


    Papers that form the basis for BONEcheck and describe the derivation of the Garvan Fracture Risk Calculators:

    • 1. Nguyen ND, Pongchaiyakul C, Center JR, Eisman JA, Nguyen TV. Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res 2005;20(11):1921-8.
    • 2. Nguyen ND, Frost SA, Center JR, Eisman JA, Nguyen TV. Development of a nomogram for individualizing hip fracture risk in men and women. Osteoporos Int 2007 Aug;18(8):1109-17.
    • 3. Nguyen ND, Frost SA, Center JR, Eisman JA, Nguyen TV. Development of Development of Prognostic Nomograms for Individualizing 5-year and 10-year Risks of Fracture. Osteoporos Int 2008;19:1431-44.
    • 4. Nguyen ND, Ahlborg HG, Center JR, Eisman JA, Nguyen TV. Residual lifetime risk of fractures in women and men. J Bone Miner Res 2007 Jun;22(6):781-8.
    • 5. Nguyen TV, Sambrook PN, Kelly PJ, Jones G, Gilbert C, Lord S, Freund J, Eisman JA. Prediction of osteoporotic fractures by postural instability and bone density. Br Med J 1993; 307:1111-1115.
    • 6. Nguyen TV, Eisman JA, Kelly PJ, Sambrook PN. Risk factors for osteoporotic fractures in men. Am J Epidemiol 1996;144:255-263.
    • 7. Nguyen TV, Center JR, Sambrook PN, Eisman JA. Risk factors for proximal humerus, forearm and wrist fractures in elderly men and women: The Dubbo Osteoporosis Epidemiology Study. Am J Epidemiol 2001; 153:587-595.

    Papers that review current fracture risk assessment tools:

  1. 1. Nguyen TV, Eisman JA. Fracture risk assessment: from population to individual. J Clin Densitom 2017;20:368-378.
  2. 2. Nguyen TV. Individualized fracture risk assessment: State-of-the-art and room for improvement. Osteoporosis and Sarcopenia 2018;4:2-10.
  3. 3. Nguyen TV (2020). Toward the era of precision fracture risk assessment. J Clin Endocrinol Metab. pii: dgaa222.
  4. 4. Nguyen TV. Personalized fracture risk assessment: where are we at? Expert Review in Endocrinology and Metabolism 2021;16(4):191-200.
  5. 5. Nguyen TV. Personalised assessment of fracture risk: which tool? Aust J Gen Pract 2022;51:189-190.

  6. Papers that describe the concept of 'Skeletal Age':

  7. 1. Ho-Le TP, Tran TS, Bliuc D, Pham HM, Frost SA, Center JR, Eisman JA, Nguyen TV. Epidemiological transition to mortality and refracture following an initial fracture. eLife 2021;10:e61142.
  8. 2. Tran TS, Ho-Le TP, Bliuc D, Abrahemsen B, Hansen L, Vestergaard P, Center JR, Nguyen TV. Skeletal age for mapping the impact of fracture on mortality. eLife 2023.

  9. Papers that describe the concept of 'Osteogenomic Profile':

  10. 1. Nguyen TV, Eisman JA. Genetic profiling and individualized assessment of fracture risk. Nat Rev Endocrinol 2013;9(3):153-61.
  11. 2. Ho-Le TP, Center JR, Eisman JA, Nguyen HT, Nguyen TV. Prediction of Bone Mineral Density and Fragility Fracture by Genetic Profiling. J Bone Miner Res 2017;32:285-293.
  12. 3. Nguyen TV. Individualized assessment of fracture risk: contribution of "osteogenomic profile". J Clin Densitom 2017;20:353-359.
  13. 4. Ho-Le TP, Pham HM, Center JR, Eisman JA, Nguyen HT, Nguyen TV. Prediction of changes in bone mineral density in the elderly: contribution of "osteogenomic profile". Arch Osteoporos. 2018;13(1):68.
  14. 5. Ho-Le TP, Tran HTT, Center JR, Eisman JA, Nguyen HT, Nguyen TV. Assessing the clinical utility of genetic profiling in fracture risk prediction: a decision curve analysis. Osteoporos Int 2021;32:271–280.

  15. Selected papers that reported results of validation studies:

  16. 1. Pluskiewicz W, Adamczyk P, Franek E, et al. Ten year probability of osteoporotic fracture in 2012 Polish women assessed by FRAX and nomogram by Nguyen et al – Conformity between methods and their clinical utility. Bone 2010;46(6):1661–67.
  17. 2. Sandhu SK, Nguyen ND, Center JR, Pocock NA, Eisman JA, Nguyen TV. Prognosis of fracture: evaluation of predictive accuracy of the FRAX algorithm and Garvan nomogram. Osteoporos Int 2010;21:863-71.
  18. 3. Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA, et al. Independent clinical validation of a Canadian FRAX tool: fracture prediction and model calibration. J Bone Miner Res 2010;25(11):2350-8.
  19. 4. Langsetmo L, Nguyen TV, Nguyen ND, et al. Independent external validation of nomograms for predicting risk of low-trauma fracture and hip fracture. CMAJ 2011;183(2):E107–14. doi: 10.1503/cmaj.100458.
  20. 5. Bolland MJ, Siu AT, Mason BH, et al. Evaluation of the FRAX and Garvan fracture risk calculators in older women. J Bone Miner Res 2011;26(2):420–27.
  21. 6. Pluskiewicz W, Adamczyk P, Franek E, et al. FRAX calculator and Garvan nomogram in male osteoporotic population. Aging Male 2014;17(3):174–82.
  22. 7. Holloway-Kew KL, Zhang Y, Betson AG, et al. How well do the FRAX (Australia) and Garvan calculators predict incident fractures? Data from the Geelong Osteoporosis Study. Osteoporos Int 2019;30(10):2129–39.
  23. 8. .Dagan N, Cohen-Stavi C, Leventer-Roberts M, Balicer RD. External validation and comparison of three prediction tools for risk of osteoporotic fractures using data from population based electronic health records: retrospective cohort study. BMJ. 2017 Jan 19;356:i6755. doi: 10.1136/bmj.i6755.
  24. 9. Crandall CJ, Larson J, LaCroix A, Cauley JA, LeBoff MS, Li W, LeBlanc ES, Edwards BJ, Manson JE, Ensrud K. Predicting Fracture Risk in Younger Postmenopausal Women: Comparison of the Garvan and FRAX Risk Calculators in the Women's Health Initiative Study. J Gen Intern Med. 2019 Feb;34(2):235-242.
  25. 10. Inderjeeth CA, Raymond WD. Case finding with GARVAN fracture risk calculator in primary prevention of fragility fractures in older people. Arch Gerontol Geriatr 2020;86:103940. doi: 10.1016/j.archger.2019.103940.

  26. Other relevant papers:

  27. 1. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 2008;19:385-397.
  28. 2. Borgström F, Johnell O, Kanis JA, Jönsson B, Rehnberg C. At what hip fracture risk is it cost-effective to treat? International intervention thresholds for the treatment of osteoporosis. Osteoporos Int2006 Oct;17(10):1459-71.
  29. 3. Tosteson AN, Melton LJ 3rd, Dawson-Hughes B, Baim S, Favus MJ, Khosla S, Lindsay RL. Cost-effective osteoporosis treatment thresholds: the United States perspective. 20. Osteoporos Int 2008 Feb 22.