How computer modelling can help improve bone health and reduce osteoporotic fractures

Osteoporosis affects around two in three Australians over 50. It’s a major underlying cause of broken bones, with the number of people hospitalised for osteoporotic fractures steadily on the rise due to our ageing population. Developing a strategy to reduce fractures in people with osteoporosis is critical not just to improving the wellbeing of older Australians but also to keeping health budgets under control.

Computer simulation tools can be used to make better decisions about where money should be spent to improve bone health. Using extensive research and clinical evidence, Sax Institute researchers modelled a “what-if” tool to test ways of reducing bone fractures in people with osteoporosis. In a new paper published in the Medical Journal of Australia, the Sax team, along with researchers from Monash University and other institutions, used the model to focus in particular on the efficacy of Fracture Liaison Services (FLS) in reducing secondary osteoporotic fractures. 

These specialist-led, in-hospital services, which assess people presenting with minimal trauma fractures for osteoporosis, have recently found favour in public health policy. Twenty-nine are now operating in Australia and a major initiative of the Federal Health Department’s 2019 National Strategic Action Plan for Osteoporosis is to increase this number to a hundred.

But will this strategy work? The team modelled scenarios for different fracture rates, number of FLSs and frequency of screening over a period up to 2030. What they found was that FLSs may not be the silver bullet that some public health policymakers would like to think they are. Increasing the number of FLSs to 100, as well doubling their screening rate and capacity, would have only the minimal effect of averting fewer than one percent of secondary osteoporotic fractures, at a cost of over $42,000 per fracture averted, the researchers found.

“While Fracture Liaison Services are an important part of preventing recurrent fractures, they can be expensive and complex to set up, and therefore need to run when, where, and in such a way that they can have the greatest impact on the most people who need their services,” says Dr Danielle Currie, Deputy Director of Simulation Modelling at the Sax Institute and one of the paper’s authors.

“Dynamic modelling provides policymakers with useful insights into what FLSs may be able to deliver, before committing to a costly strategy of expanding their number,” she adds.

The dynamic simulation model was commissioned by Amgen Australia and developed independently by the Sax Institute.

Read the full paper here

Watch a video on our osteoporosis modelling here.

Find out more about our simulation modelling tools here.