ABSTRACT
OBJECTIVES: To compare and assess the performance of 6 osteoporosis risk assessment tools for screening osteoporosis in Malaysian postmenopausal women. METHODS: Six osteoporosis risk assessments tools (the Simple Calculated Osteoporosis Risk Estimation [SCORE], the Osteoporosis Risk Assessment Instrument, the Age Bulk One or Never Estrogen, the body weight, the Malaysian Osteoporosis Screening Tool, and the Osteoporosis Self-Assessment Tool for Asians) were used to screen postmenopausal women who had not been previously diagnosed with osteoporosis/osteopenia. These women also underwent a dual-energy X-ray absorptiometry (DXA) scan to confirm the absence or presence of osteoporosis. RESULTS: A total of 164/224 participants were recruited (response rate, 73.2%), of which only 150/164 (91.5%) completed their DXA scan. Sixteen participants (10.7%) were found to have osteoporosis, whilst 65/150 (43.3%) were found to have osteopenia. Using precision-recall curves, the recall of the tools ranged from 0.50 to 1.00, whilst precision ranged from 0.04 to 0.14. The area under the curve (AUC) ranged from 0.027 to 0.161. The SCORE had the best balance between recall (1.00), precision (0.04–0.12), and AUC (0.072–0.161). CONCLUSIONS: We found that the SCORE had the best balance between recall, precision, and AUC among the 6 screening tools that were compared among Malaysian postmenopausal women.
Subject(s)
Female , Humans , Absorptiometry, Photon , Area Under Curve , Body Weight , Bone Diseases, Metabolic , Estrogens , Malaysia , Mass Screening , Osteoporosis , Risk Assessment , Self-AssessmentABSTRACT
BACKGROUND: We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. METHODS: Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. RESULTS: Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. CONCLUSION: The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.
Subject(s)
Humans , Male , Absorptiometry, Photon , Asian People , Bone Density , Korea , Mass Screening , Nutrition Surveys , Osteoporosis , ROC Curve , Sample Size , Self-Assessment , Sensitivity and SpecificityABSTRACT
BACKGROUND: We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. METHODS: Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. RESULTS: Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. CONCLUSION: The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.
Subject(s)
Humans , Male , Absorptiometry, Photon , Asian People , Bone Density , Korea , Mass Screening , Nutrition Surveys , Osteoporosis , ROC Curve , Sample Size , Self-Assessment , Sensitivity and SpecificityABSTRACT
Objective To evaluate the application of osteoporosis self-assessment tool for Asians (OSTA) in screening of osteoporosis for postmenopausal women in community.Methods Total 793 postmenopausal women were included.OSTA were calculated and bone mineral density (BMD)was measured by dual energy X-ray absorptiometry (DXA).The correlation of OSTA index with DXA results was analyzed.Results The prevalence of osteoporosis and osteopenia was 18.3％ (145/793) and 47.7％(378/793) respectively,the remaining 270 women had normal bone mass (34.0％).According to OSTA index the rate of low-risk,medium-risk,high-risk osteoporosis groups were 61.9％ (491/793),29.5％(234/793) and 8.6％ (68/793),respectively.The BMD measured by DXA was positively correlated with OSTA index(r =0.559,P =0.000).The area under receiver operating characteristic curve (ROC) of OSTA for diagnosing osteoporosis was 0.736.Taking-1 as cut off value,the sensitivity and specificity of OSTA in diagnosis of osteoporosis was 73.1％ (106/145) and 69.8％ (452/648),respectively.Conclusion OSTA can be used as an effective index for screening of osteoporosis in postmenopausal women in community.
ABSTRACT
Objective To evaluate the screening effect of OSTA in Chinese post-menopausal women, to provide suggestions for the further development of OP screening in mainland China. Methods With the data from Chinese Database of Bone Mineral Density of Chinese women aged 50 years old and above, each subject was calculated a OSTA score by the formula of OSTA and classified into three risk levels (the normal, the osteopenia and the osteoporosis) or two groups (the low and the high risk) by the original cutoffs, and compared with results by T-score. A series of screening indexes, such as sensitivity, specificity, kappa value and ROC etc., were employed to compare and analyze the diagnosis results of OSTA with T-score from the femoral neck bone density. Results According to the 3 levels by original cutoffs, the Kappa value was 0.357 (P