The Amgen REFRAME app provides easy access to reporting relating to patients that have osteoporosis risk factors and gives the users a simple view of the patient's risk and other relevant factors in one table.

The app will apply the following patients:

  • Patients 70 years of age and older and never had a DXA, or have not had a DXA within the last 2 years

Or

  • Patients that have experienced a fracture since the age of 50


When a patient meeting one of the criteria above is opened in your clinical system, the app will become active and show a notification in a red circle:



Clicking on the app icon will open it in full screen and display all relevant information in a table view:



If there is no information in the patient record, only the name of the indicator will be displayed. If the information is available, it will be displayed in green.

The following columns will be displayed within the app and populated if the data is stored within the patients record in a coded format. Full details on the mapping and background can be found here: REFRAME Data Mapping


ItemColumn NameData Mapping

1

>=70yrs and no DXA or >2yrs since last DXA

green tick, date and additional details or blank (nothing displayed)

2

Experienced a fracture since age of 50

green tick, date and additional details or blank (nothing displayed)

3

Osteoporosis

green tick, date and additional details or blank (nothing displayed)

4

Minimum Trauma Fracture

green tick, date and additional details or blank (nothing displayed)

5

Received bone active medication in the last 5yrs

green tick, date and additional details or blank (nothing displayed)

6

Glucocorticoid drug class >7.5mg per day for >3 months

green tick, date and additional details or blank (nothing displayed)

7

BMI <20

green tick, date and additional details or blank (nothing displayed)

8

hyperthyroidism

green tick, date and additional details or blank (nothing displayed)

9

Smoking

green tick, date and additional details or blank (nothing displayed)

10

Coeliac Disease

green tick, date and additional details or blank (nothing displayed)

11

Primary Hyperparathyroidism

green tick, date and additional details or blank (nothing displayed)

12

Previous treatment with aromatase inhibitor drug class

green tick, date and additional details or blank (nothing displayed)

13

History of poor calcium intake

green tick, date and additional details or blank (nothing displayed)

14

History of low vitamin D

green tick, date and additional details or blank (nothing displayed)

15

Inflammatory conditions associated with bone loss

green tick, date and additional details or blank (nothing displayed)

16

CKD

Please see below for details on this indicator

17

Diagnosis Sarcopenia

green tick, date and additional details or blank (nothing displayed)

18>=70yrs and no DXA or >5yrs since last DXA

green tick, date and additional details or blank (nothing displayed)

19Lapsed Osteoporosis medication >12mths and <5yrs

green tick, date and additional details or blank (nothing displayed)

CKD displays stages of CKD (indicated or diagnosed) as well as likelihood of the indication based on the extracted pathology
results.

  • Indicated Staging of CKD

Patients on dialysis are displayed as 'level 5' CKD.


For more information refer to Kidney Health Australia web site and the CKD Guideline Booklet available at www.kidney.org.au
Detection of CKD requires follow up testing once an abnormal result is recorded. The outcome of 3 tests over a 3 month
period will inform a diagnosis. CAT4 is only using the most recent eGFR and ACR, not the last 3 results. This will

•inform a diagnosis if 3 tests have been done or
•flag that a patient should be recalled for follow up testing if there are not 3 results in the Patient Record.

For full details on the CKD stage calculation please see here: http://kidney.org.au/cms_uploads/docs/02_algorithm-for-inital-detection-of-ckd.pdf