Crandall CJ, et al. - Researchers assessed the performance of the Fracture Risk Assessment Tool (FRAX) and FRAX-based osteoporosis treatment thresholds under the US National Osteoporosis Foundation and UK National Osteoporosis Guideline Group guidelines among women aged ≥ 40 years. They found a good calibration in FRAX-predicted vs observed 10-year major osteoporotic fracture (MOF) and hip fracture likelihood. They used population-based health services data (mean follow-up 10.5 years) to evaluate incident MOF, hip fracture, and clinical fracture. Findings revealed low sensitivity and positive predictive value of the strategies based on dichotomous cut-offs, particularly in women aged 40 to 49 years (who have the lowest incidence rates). Experts recommended a reevaluation of threshold-based approaches, especially in younger women.