Holloway-Kew KL, et al. - Women (n=809) and men (n=821) aged 50–90 years who were recruited in the Geelong Osteoporosis Study were included by the researchers in order to evaluate the ability of the FRAX (Australia) and Garvan calculators to prognosticate fractures in Australian women and men. Using FRAX and Garvan calculators, fracture risk was assessed with and without femoral neck bone mineral density (BMD). Incident major osteoporotic (MOF), fragility, and hip fractures over the following 10 years were validated radiologically. One hundred and fifteen vs 73 MOF, 184 vs 109 fragilities, and 42 vs 17 hip fractures occurred in women and men, respectively. Despite the sex or inclusion of BMD, FRAX underestimated MOFs. Except in women with BMD, FRAX accurately prognosticated hip fractures and in men using BMD, Garvan underestimated fragility fractures. Except for women without BMD, Garvan accurately prognosticated hip fractures. Principally in the osteopenia and osteoporosis groups, fractures were underestimated and both in men, MOFs in the normal BMD group were only underestimated by FRAX_BMD and fragility fractures by Garvan_noBMD. No variations in the AUROCs between scores with and without BMD was observed, except for fragility fractures prognosticated by Garvan in women and men, which almost reached importance. The MOFs and fragility fractures were poorly prognosticated by both FRAX and Garvan, while hip fractures were acceptably foretold as exhibited by the analyses of sensitivity and specificity. Hence, especially in people with osteopenia or osteoporosis, the FRAX and Garvan calculators overall underestimated MOF and fragility fractures. Both calculators better predicted hip fractures. moreover, for the prognostication of fragility fractures, AUROC analyses inferred that Garvan_BMD performed better than Garvan_noBMD.