Performance of the Osteoporosis Self-assessment Screening Tool for Osteoporosis in American Men

Adler, Robert A.; Tran, Mongthuong T.; Petkov, Valentina I.

doi:10.4065/78.6.723

Cited by 85 publications

(64 citation statements)

References 8 publications

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“…They found that the OST predicted osteoporosis as measured by DXA, using cutoffs similar to postmenopausal women (OST<2) and reported a sensitivity and specificity of 79% and 51%, respectively, for the Rotterdam study and 88% and 32% for the Baltimore cohort. Adler et al [34] used a multi-ethnic sample of men extracted from pulmonary and rheumatology clinics at an American veteran's hospital and using a cutoff of OST<3, obtained a sensitivity of 93%, and a specificity of 66%. Kung et al [35], in a large sample of Chinese men, validated the OST using a different cutoff (OST<0), with a sensitivity of 81% and specificity of 66%.…”

Section: Discussionmentioning

confidence: 99%

“…They have been validated for women of diverse origins, including Asian and Caucasian [3,[28][29][30][31][32]. The evidence for the utility of these rules in a clinical setting is scarce and few studies have been performed in men [33][34][35][36][37][38][39][40]. Their utility is not necessarily the same in males and females and in different populations, as the contribution of osteoporotic factors may vary.…”

Section: Introductionmentioning

confidence: 99%

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Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

2009

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Summary Clinicians need tools to identify patients most likely to benefit from bone mineral density (BMD) testing, for which cost-effectiveness does not allow generalized screening. This study supports the utility of osteoporosis risk assessment tools in selecting men for BMD testing. Different cutoff values may be appropriate for different countries and/or ethnic origins. Introduction Our aim was to evaluate the utility of three osteoporosis (OP) risk assessment tools in a large group of Portuguese men aged 50 or more and to determine the best cutoff value to be used for selecting men for bone densitometry. Methods We assessed the performance of three simple tools in 202 randomly selected men: body weight criterion (BWC), osteoporosis self-assessment tool for Asians (OSTA), and a modified version of the OSTA equation (OST). Previously published cutoff values (validated in postmenopausal women) and three additional cutoff values were tested. Sensitivity (SE), specificity (SP), predictive values, and area under the receiver operating characteristic (AUROC) curve for correctly selecting men with OP (defined by BMD testing) were determined. Results Mean age of the cohort was 63.8 years. According to the World Health Organization diagnostic categories, 16.8% had osteoporosis. The best performing cutoffs for correctly selecting men with OP for BMD testing were OST<3 (SE= 75.5%, SP=50.0%, AUROC=0.632), OSTA<3 (SE=73.5%, SP=58.3%, AUROC=0.659), and BWC<75 kg (SE=73.5%, SP=61.3%, AUROC=0.674). Conclusions OP risk assessment tools seem to be useful in men aged 50 or more. Best cutoff values are different from those recommended for postmenopausal women. Different cutoff values may be appropriate for different countries and/or ethnic origins.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

2009

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“…The calculated risk index is based on self-reported age and weight: [(weight in kilograms -age in years) × 0.2, truncated to an integer]. It was developed and validated in several studies in Asian and White women (Richy, Ethgen et al 2004;El Maghraoui, Guerboub et al 2007;El Maghraoui, Habbassi et al 2007) and men (Adler, Tran et al 2003;Ghazi, Mounach et al 2007). …”

Section: Who Should Have a Dxa Measurement?mentioning

confidence: 99%

Interpreting a DXA Scan in Clinical Practice

Maghraoui¹

2012

Dual Energy X-Ray Absorptiometry

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“…In Table 5 the construct validity of some of these is shown and compared to that of the current study. [9][10][11][12][13][14][15][16][17][18][19] Although sensitivity of the majority of these instruments is high, most are limited by moderate specificity and PPV. The Dutch case-finding instrument showed the poorest outcomes.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…2,6 To date, several case-finding instruments have been developed and validated. [9][10][11][12][13][14][15][16][17][18] However, there is no universally accepted policy.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Dutch guidelines for dual X-ray absorptiometry measurement

Verdijk

Romeijnders²,

Ruskus³

et al. 2009

Br J Gen Pract

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In Europe, a case-finding strategy for osteoporosis is recommended above widespread population-based screening. However, no universally accepted policy currently exists. In 2005, the Dutch College of General Practitioners published guidelines for GPs to select patients for dual energy X-ray absorptiometry (DXA). AimTo evaluate the sensitivity, specificity, and predictive value of the Dutch guidelines to select participants with osteoporosis for DXA. Design of studyCross-sectional. SettingA total of 345 females aged over 50 years (mean age = 62 years, standard deviation [SD] = 8.3) and 99 males over 65 years of age (mean age = 72 years, SD = 5.2) of a Dutch general practice. MethodCalculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Dutch case-finding instrument for selecting patients with osteoporosis for DXA measurement. ResultsSensitivity was 19.5%, specificity 85.6%, PPV 18.6%, and NPV 86.6%. ConclusionThe Dutch guidelines are unreliable in detecting people at risk for osteoporosis. KeywordsDEXA scan; osteoporosis; practice guideline; predictive value of tests; sensitivity and specificity. INTRODUCTIONOsteoporosis is a major public health issue: osteoporotic fractures affect one in two women and one in five men aged >50 years.1 In 2000, the number of osteoporotic fractures in the European Union was estimated at 3.8 million, equalling a financial burden €31.7 billion. It is expected that by 2050, the direct cost of fractures in Europe will exceed €75 billion. 2The annual incidence of fractures in the UK is estimated at 310 000 with costs of €2.4 billion. 3 In the Netherlands over 430 000 patients have osteoporosis 4 and about 83 000 people aged >55 years have a fragility fracture each year. 5Considering the growing incidence, fracture prevention and thus early diagnosis of osteoporosis are of great importance, especially since pharmacological treatment of osteoporosis has been shown to be cost-effective, irrespective of age. 6Diagnosis of osteoporosis is currently based on bone densitometry, usually by dual energy X-ray absorptiometry (DXA). Bone mineral density is widely recognised as a major predictor for fractures. 7 However, case-finding strategy has been shown to be more cost-effective than population-based NA Verdijk, MSc, PhD candidate; VJ Pop, professor of primary care, the

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Performance of the Osteoporosis Self-assessment Screening Tool for Osteoporosis in American Men

Cited by 85 publications

References 8 publications

Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

Interpreting a DXA Scan in Clinical Practice

Validation of the Dutch guidelines for dual X-ray absorptiometry measurement

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