Biopsychosocial assessment tools for the elderly – Assessment summary sheet

Test: Fracture and Mortality (FRAMO) Index

Year: 2007

Doman: Biological

Assessment Tool Category: Clinical risk assessment / clinical prediction guide

Variations/translations: None known

Setting: Any setting of elderly persons.

Method of delivery: Interviewer asks questions, requires verbal responses. Questionnaire may also be filled out directly by the client.

Description: The FRAMO index was developed as a clinical predictor of fracture and mortality risk in order to identify patients who may be candidates for more intensive preventative measures. It contains four simply worded questions with yes / no answers. The FRAMO index identified the majority of women experiencing hip fractures during the 2 year follow up study period. It was recently revalidated and correlated with portable heel bone mineral density (BMD) to further refine the high risk group category.

Scoring/interpretation: Binary scoring system: score is 1 for yes and 0 for no. Scores of 0 to 1 deemed low risk and 2 to 4 indicate high risk for fracture.

Time to administer: A few minutes.

Availability: contact author, Daniel Albertsson: daniel.albertsson@ltkronoberg.se

Software: N/A

Website:

http://rgps.on.ca/giic/GiiC/pdfs/1%20Osteoporosis%20&%20Fracture%20Prevention
%20%20-%20FRAMO%20Risk%20INDEX%20Primary%20Care.pdf

Qualitative/Quantitative: Quantitative

Validity: Predictive validity: 81% sensitivity, 64% specificity for hip fracture risk; 81% sensitivity, 67% specificity for mortality.

Reliability: Not known.

References:

Albertsson, D. M., Mellstrom, D., Petersson, C., & Eggertson, R. (2007) Validation of a 4-item score predicting hip fracture and mortality risk among elderly women. Annals of Family Medicine, 5, 48-56.

Albertsson, D. M., Mellstrom, D., Petersson, C., Thulesius, H. & Eggertson, R. (2010) Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study. BMC Musculoskeletal Disorders, 11, 55. Retrieved from http://www.biomedcentral.com/1471-2474/11/55/abstract on March 24, 2010.

Gill, S. (2007) The 4-item Fracture and Mortality Index predicted hip fracture and all cause mortality in elderly women. Evidence-Based Medicine, 12(4), 122.

Comments: The FRAMO index was validated in white, rural, Swedish female populations. It has yet to be modified for males. Gill (2007) has advocated for further validation and study in other cohorts before wider application by clinicians.