Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Su, Fu-Mei; Liu, Dung-Huan; Chen, Jiafeng; Yu, Shan‐Fu; Chiu, Wen-Chan; Hsu, Chung‐Yuan; Ko, Chun-Han; Tsai, Ching‐Chou; Cheng, Tien‐Tsai

doi:10.1371/journal.pone.0130716

Cited by 23 publications

(24 citation statements)

References 26 publications

(36 reference statements)

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“… 9 OSTA has performed well and has been found to be cost-effective for Asians in many studies. 10 – 12 However, some studies reported poor results when validating OSTA’s effectiveness in identifying postmenopausal osteoporosis in a Chinese cohort. 13 , 14 Thus, we were motivated to develop a new screening tool for postmenopausal Chinese women to assess the risk of DXA-determined primary osteoporosis and chose OSTA as a comparison.…”

Section: Introductionmentioning

confidence: 99%

BFH-OST, a new predictive screening tool for identifying osteoporosis in postmenopausal Han Chinese women

Yang

Lin

et al. 2016

CIA

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PurposeTo develop a simple new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in postmenopausal women and to compare its validity with the Osteoporosis Self-Assessment Tool for Asians (OSTA) in a Han Chinese population.MethodsA cross-sectional study was conducted, enrolling 1,721 community-dwelling postmenopausal Han Chinese women. All the subjects completed a structured questionnaire and had their bone mineral density measured using DXA. Using logistic regression analysis, we assessed the ability of numerous potential risk factors examined in the questionnaire to identify women with osteoporosis. Based on this analysis, we build a new predictive model, the Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OST). Receiver operating characteristic curves were generated to compare the validity of the new model and OSTA in identifying postmenopausal women at increased risk of primary osteoporosis as defined according to the World Health Organization criteria.ResultsAt screening, it was found that of the 1,721 subjects with DXA, 22.66% had osteoporosis and a further 47.36% had osteopenia. Of the items screened in the questionnaire, it was found that age, weight, height, body mass index, personal history of fracture after the age of 45 years, history of fragility fracture in either parent, current smoking, and consumption of three of more alcoholic drinks per day were all predictive of osteoporosis. However, age at menarche and menopause, years since menopause, and number of pregnancies and live births were irrelevant in this study. The logistic regression analysis and item reduction yielded a final tool (BFH-OST) based on age, body weight, height, and history of fracture after the age of 45 years. The BFH-OST index (cutoff =9.1), which performed better than OSTA, had a sensitivity of 73.6% and a specificity of 72.7% for identifying osteoporosis, with an area under the receiver operating characteristic curve of 0.797.ConclusionBFH-OST may be a powerful and cost-effective new clinical risk assessment tool for prescreening postmenopausal women at increased risk for osteoporosis by DXA, especially for Han Chinese women.

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Section: Introductionmentioning

confidence: 99%

BFH-OST, a new predictive screening tool for identifying osteoporosis in postmenopausal Han Chinese women

Yang

Lin

et al. 2016

CIA

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“…The current investigation was based on the Taiwan OsteoPorosis Survey (TOPS) database . In brief, a circuit program for BMD measurements was conducted by the Taiwan Osteoporosis Association (TOA) from 2008 to 2011.…”

Section: Methodsmentioning

confidence: 99%

High prevalence and correlates of osteoporosis in men aged 50 years and over: A nationwide osteoporosis survey in Taiwan

et al. 2018

Int J of Rheum Dis

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Aims Osteoporosis is one of the consequences of aging, and it remains underdiagnosed and undertreated; this study aimed to present the characteristics and prevalence of osteoporosis in elderly men by conducting a nationwide survey in Taiwan. Methods The participants were enrolled between 2008 and 2011, and bone mineral density (BMD) was measured via dual‐energy X‐ray absorptiometry for the hip (total), lumbar spine (L1‐4), and femoral neck (FN). Patients with rheumatoid arthritis, female patients, and those using steroids were excluded. Osteoporosis was defined as a T‐score at the FN of ≤−2.5. Results This study included 3734 men of mean age 70.0 ± 9.3 years, accounting for the prevalence of osteoporosis at 9.7%. Participants with osteoporosis had a significantly older age, lower body weight, shorter height and more previous fractures than those without osteoporosis. The mean BMD at FN was 0.534 ± 0.056 and 0.791 ± 0.115 (g/cm2) in participants with and without osteoporosis, respectively (P < 0.001). The FN and hip (total) BMD showed a significant negative correlation with age (r = −0.234, P < 0.001) and (r = −0.003, P < 0.001), respectively, but not at L1‐4 (r = 0.00, P = 0.540). A history of fracture is the most important risk factor associated with male osteoporosis (odds ratio, 2.50; 95% CI, 1.49‐4.21; P = 0.006). Conclusions The associated factors for male osteoporosis are aging, lower body weight, and a history of fracture; the BMDs at FN and hip (total), but not L1‐4, are inversely correlated with age. We recommend that BMD at the proximal femur be the preferred site to evaluate osteoporosis for elderly male subjects.

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“… 7 OSTA has been found to be cost-effective for postmenopausal OP in many studies. 8 – 10 However, the research about the validation of OSTA to identify primary OP in elderly male has seldom been published. Thus, we were motivated to develop a new screening tool for elderly Chinese male to assess the risk of DXA-determined primary OP and choose OSTA as a comparison.…”

Section: Introductionmentioning

confidence: 99%

BFH-OSTM, a new predictive screening tool for identifying osteoporosis in elderly Han Chinese males

Lin¹,

Yang²,

Zhang³

et al. 2017

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PurposeTo develop and validate a new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in two elderly Han Chinese male populations.MethodsA cross-sectional study was conducted, enrolling 1,870 community-dwelling and 574 hospital-checkup elderly Han Chinese males aged ≥50 years. All subjects completed a structured questionnaire and had their bone mineral density (BMD) measured using DXA. Using logistic regression analysis in the 1,870 community-dwelling males, we assessed the ability of numerous potential clinical risk factors to identify male with osteoporosis. Multiple variable regression analysis and item reduction yielded a final tool named the Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM). Receiver operating characteristic (ROC) curve was generated to compare the validation of the BFH-OSTM and Osteoporosis Self-assessment Tool for Asians (OSTA) for identifying elderly male at increased the risk of primary osteoporosis in the 574 hospital-checkup males.ResultsIn screening the 1,870 community-dwelling subjects with DXA, 14.2% (266/1,870) had osteoporosis, and a further 51.8% (969/1,870) had osteopenia. Of the items screened in the questionnaire, weight, height and previous history of fragility fracture were predictive of osteoporosis. A final tool (BFH-OSTM) was based on body weight and fragility fracture history only. The BFH-OSTM index (cutoff =70) had a sensitivity of 85% and specificity of 53% for identifying osteoporosis according to the WHO criteria, with an area under the ROC curve of 0.763. The predictive value of BFH-OSTM was validated in the 574 hospital-checkup population, which performed better than OSTA.ConclusionThe BFH-OSTM may perform well for identifying elderly male at increased risk for osteoporosis and applying it would result in more prudent use of BMD measurement by DXA, especially for Han Chinese male.

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Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Cited by 23 publications

References 26 publications

BFH-OST, a new predictive screening tool for identifying osteoporosis in postmenopausal Han Chinese women

BFH-OST, a new predictive screening tool for identifying osteoporosis in postmenopausal Han Chinese women

High prevalence and correlates of osteoporosis in men aged 50 years and over: A nationwide osteoporosis survey in Taiwan

BFH-OSTM, a new predictive screening tool for identifying osteoporosis in elderly Han Chinese males

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