Fracture Liaison Service Database (FLS-DB) methodology

Produced by:

The FLS-DB audit aims to evaluate patterns of assessment and treatment for osteoporosis and falls for patients who have sustained a fragility fracture. 

The audit's objective is to improve the quality of the clinical care delivered to patients who sustain fractures through effective measurement against standards, feedback to providers and quality improvement initiatives.

Audit design

We initiated the audit to measure primarily against NICE technology assessments and guidance on osteoporosis, and the NOS clinical standards for FLSs. The FLS-DB is a continuous audit and started collecting patient-level data in January 2016. Documents mapping the datasets to evidence-based guidance are available in the downloads section.

Exclusion and inclusion criteria

Patients should:

  • be aged 50 or over, and
  • have sustained a fragility fracture that was diagnosed by the NHS after 1 January 2016.

Data processing

This audit has been granted Section 251 approval by the NHS Health Research Authority (CAG reference: 15/CAG/0158), meaning that we are allowed to collect patient-identifiable data without patient consent.

All data that will be collected by the audit programme will be processed to ensure patient confidentiality is maintained.

Analysis plan for the FLS-DB annual report

The FLS-DB team has produced a supporting document on the analysis methodology for the 2018 annual report which includes:

  • a list of the 11 key performance indicators (KPIs) used in the audit
  • the numerator and denominator for each KPI
  • data cleaning notes
  • real world data applications.

The methodology documents are available in the download section.