Researchers have developed a new algorithm that may improve upon existing methods for identifying patients at high risk for fracture in primary care. The updated “QFracture” tool, which was first introduced in 2009, predicts the risk for both osteoporotic and hip fracture and has been modified to account for ethnicity, old age, care home residence, fracture history, and a raft of additional comorbidities. Julia Hippisley-Cox (University of Nottingham, UK) and colleagues writing in the British Medical Journal said: “Validation statistics suggest that the updated algorithm is probably more effective than previous algorithms at identifying patients at high risk of fracture in primary care in the UK.” The original QFracture algorithm uses 17 variables that are readily available without recourse to laboratory tests or clinical measurements, and has been validated in a large primary care database. Two versions are available: one to predict hip fracture and one to predict osteoporotic fracture. The revised algorithms feature four major changes: the inclusion of proximal humerus fracture in the definition of osteoporotic fracture; an extended age range, allowing the tool to be used in the over-85s; 13 additional risk factors, which are easily obtainable from the patient’s medical record; and a simplified variable relating to hormone replacement therapy. An online version of the QFracture tool is available at