In this study, we compared subjective fracture risks of Hungarian women with 
osteoporosis to FRAX®-based estimates. Patients with a previous fracture, 
parental hip fracture, low femoral T-score, higher age, and higher BMI were more 
likely to underestimate their risks. Patients also failed to associate risk 
factors with an increased risk of fractures.
PURPOSE: The main objectives were to explore associations between self-perceived 
10-year fracture risks of women with osteoporosis (OP) and their risks 
calculated by the FRAX® algorithm and to identify determinants of the 
underestimation of risk.
METHODS: We carried out a cross-sectional study in 11 OP centers in Hungary and 
collected data on the risk factors considered by the FRAX® calculator. Patients 
estimated their subjective 10-year probability of any major osteoporotic and hip 
fracture numerically, in percentages and also on a visual analog scale (VAS). We 
compared subjective and FRAX® estimates and applied logistic regression to 
analyze the determinants of the underestimation of risk. Associations between 
risk factors and subjective risk were explored using linear probability models.
RESULTS: Nine hundred seventy-two OP patients were included in the analysis. 
Major OP and hip fracture risk by FRAX® were on average 20.1 and 10.5%, while 
subjective estimates were significantly higher, 30.0 and 24.7%, respectively. 
Correlations between FRAX® and subjective measures were very weak 
(r = 0.12-0.16). Underestimation of major OP fracture risk was associated with 
having had a single previous fracture (OR = 2.0), parental hip fracture 
(OR = 3.4), femoral T-score ≤-2.5 (OR = 4.2), higher age, body mass index, and 
better general health state. We did not find significant associations between 
subjective risk estimates and most of the risk factors except for previous 
fractures.
CONCLUSIONS: Hungarian OP patients fail to recognize most of the risk factors of 
fractures. Thus, education of patients about these risk factors would be 
beneficial especially for the elderly with a low femoral T-score and parental 
hip fracture history.