The USPSTF recommends using WHO's Fracture Risk Assessment (FRAX) calculator. The FRAX calculator generates a 10-year osteoporotic fracture risk based on age; gender; weight; height; parental fracture history; use of glucocorticoids; presence of RA or conditions associated with secondary osteoporosis; tobacco and heavy alcohol use; and, when available, femoral neck BMD. The FRAX calculator also provides a 10-year hip fracture risk. 

FRAX has been validated for African American, Hispanic, and Asian women in the United States and has calculators that are continent- and country-specific.

The USPSTF recommends using a 10-year osteoporotic fracture risk threshold of 9.3% when considering bone density screening in women ages 50 to 64 years. Screening decisions for women in this age range should account for menopausal status, clinical judgment, and patient preferences and values.

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