Prescreening for Osteoporosis With Quantitative Ultrasound in Postmenopausal White Women

Abstract

Objectives Calcaneal quantitative ultrasound (QUS) is a readily accessible and radiation‐free alternative to dual‐energy x‐ray absorptiometry (DXA) for assessing bone mineral density (BMD). Results obtained from QUS measurement cannot directly be compared to DXA, since these techniques capture different bone‐specific parameters. To identify individuals who are likely to have osteoporosis by DXA, device‐specific thresholds have to be defined for QUS. This cross‐sectional study evaluated the accuracy of QUS to identify postmenopausal women with osteoporosis, defined as a T score of –2.5 SDs or lower by DXA, and to calculate device‐specific cutoff values for the QUS device investigated. Methods We assessed BMD at the lumbar spine, bilateral femoral neck, and total hip sites with DXA and QUS parameters of the right and left calcanei in a cohort of 245 postmenopausal treatment‐naïve women between 40 and 82 years. Correlation coefficients for BMD and QUS parameters were calculated. Receiver operating characteristic curves were generated, and areas under the curves (AUCs) were evaluated. Cutoff values for QUS were defined. Results Calcaneal QUS had the ability to identify postmenopausal women with a T score of –2.5 or lower at the right hip (AUC, 0.887) and left femoral neck (AUC, 0.824). Cutoff values for the QUS T scores at the right (–1.455) and left (–1.480) calcanei were defined for screening purposes. Conclusions This study provides insights into the comparative performance of QUS with DXA. Considering the diagnostic accuracy of this modality in comparison to DXA, it can be recommended as a prescreening tool to reduce the number of DXA screenings.

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

“…On the other hand, QUS was not effective in identifying subjects with osteoporosis in the present study (Table 4). This observation is contradictory to earlier studies which reported a satisfactory performance of QUS (of different manufacturers) in identifying people with osteoporosis defined by T-score [21,39]. [41].…”

“…Particularly, the performance of CM-200 in identifying subjects at risk of osteoporosis changed from ineffective to effective ( Table 5). Some of the previous studies have applied modified QUS T-score to determine the optimal performance of QUS in identifying subjects at risk of osteoporosis [21,[42][43][44]. Oral et al (2019) found that at the modified QUS T-scores of −1.68 and −1.53 for men (mean age: 57.8 ± 13.7 years) and women (mean age: 53.7 ± 11.9 years), respectively, the sensitivity and specificity values obtained were around 70% [40].…”

“…According to the International Society for Clinical Densitometry (ISCD), the calcaneus is the only validated anatomical site recommended for osteoporosis screening [18]. Previous studies have proved that calcaneal QUS is useful for early detection of osteoporosis [19][20][21]. However, the use of WHO's T-score cut-offs for osteoporosis and osteopenia in QUS remains controversial because the cut-off values of <−1 and ≤−2.5 are established based on DXA and the skeletal properties examined are different between QUS and DXA [18].…”

Screening for Osteoporosis – Making an Informed Choice of DXA or Calcaneal QUS

“…[24] Based on the population data, investigators have found that -1.455 for the right QUS T score and -1.48 for the left QUS T score achieved adequate screening parameters to identify Osteoporosis. [25] Cutoff scores produced a sensitivity of 41% and a specificity of 86.6% for the right QUS T score and a sensitivity of 51.3% and a specificity of 83.3% for the left QUS T score. With a higher QUS T score cut-off of -1.25, sensitivity was higher at 80.4% with a specificity of 59.7% as seen in a study from China.…”

AZINLIK HAKLARI ile YERLİ HALKLARIN HAKLARININ KOLEKTİF HAK KULLANIMI ÇERÇEVESİNDE KARŞILAŞTIRILMASI

“…Özerklik gibi grup haklarını teminat altına alan uygulamalar grubun içindeki farklılıkları bastıran bir niteliğe sahip olabilir. Grup içinde kendini farklı hisseden kişiler bakımından ayrımcı muamelenin söz konusu olması insan hakları koruma mekanizmalarının kendisinden beklenen amacı gerçekleştirememesi sonucunu doğurabilmektedir 61 . Alman azınlığın yoğun yaşadığı İtalya'nın Güney Tirol bölgesinde İtalyan etnik kökenine sahip kişilerin çok büyük kısmı Movimento Sociale Italiano adlı İtalyan Faşist partisine oy vermekte, bir kısmı da bölgeyi terk etmektedir 62 .…”