The difference between hazard and risk in the relation between bone density and fracture

Calcif Tissue Int. 2007 Jun;80(6):349-52. doi: 10.1007/s00223-007-9022-4. Epub 2007 May 23.

Abstract

The relation between fracture risk and bone density is frequently defined in terms of a relative hazard derived from the Cox proportional hazards model. The relative hazard is a multiplicative factor representing the rise in hazard for each standard deviation fall in bone mineral density, which has a typical value of about 1.5. It is not generally appreciated that this hazard may only be equated with absolute risk when risk is very low; at higher risk and over long periods, it is inappropriate to apply a multiplicative factor to absolute risk because risk has a range of 0-1 and cannot exceed unity. Here, we show how "hazard" can be converted to risk and how misleading the current practice of equating relative hazards with relative risks can be.

MeSH terms

  • Aged
  • Bone Density*
  • Female
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / etiology
  • Humans
  • Proportional Hazards Models
  • Risk
  • Risk Assessment
  • Time Factors