The performance of osteoporosis self-assessment tool for Asians (OSTA) in identifying the risk of osteoporosis among Malaysian population aged 40 years and above

Subramaniam, Shaanthana; Chan, Chin Yi; Soelaiman, Ima Nirwana; Mohamed, Norazlina; Muhammad, Norliza; Ahmad, Fairus; Ng, Pei Yuen; Jamil, Nor Aini; Aziz, Nor Azlina Abd; Chin, Ken Min

doi:10.1007/s11657-019-0666-2

Cited by 24 publications

(22 citation statements)

References 33 publications

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“…In addition, the subjects recruited by Koh et al (2001) were from the clinics and tertiary centers, while the subjects of the current study were recruited from the community-dwelling population. The adjusted OSTA cut-off values (1.8 for men, 0.8 for women) were proven to be effective in identifying individuals with osteoporosis within the same cohort of subjects previously [8]. The performance of the newly developed algorithms is comparable with the performance of OSTA at its adjusted cut-off values.…”

Section: Discussionmentioning

confidence: 92%

“…Moreover, these algorithms demonstrated a better performance in identifying subjects with osteoporosis as compared to using OSTA with its existing cut-off values in the same cohort of subjects [16]. OSTA was not predictive among these subjects [8], as evidenced by the low sensitivity, specificity and AUC values (Table 5), which are in contrast to the findings by Koh et al (2001) [5]. This discrepancy is due to the differences in characteristics of the cohort for the establishment of OSTA and the Malaysian populations.…”

Section: Discussionmentioning

confidence: 99%

“…This study is a part of the cohort study investigating the bone health of Malaysians living in Klang Valley, Malaysia [8,[13][14][15]. This cross-sectional study initially recruited 786 community-living Malaysians aged ≥40 years living in Klang Valley, Malaysia using quota sampling technique.…”

Section: Study Populationmentioning

confidence: 99%

“…Osteoporosis Self-Assessment Tool for Asians (OSTA) is an alternative screening algorithm developed for Asians [5,7]. However, our previous study showed that OSTA at its original cut-off (< -4 for high risk; -4 to -1 for low risk) values did not predict osteoporosis among Malaysian men and women >40 years [8].…”

Section: Introductionmentioning

confidence: 97%

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Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

Subramaniam

Chan

Soelaiman

et al. 2020

IJERPH

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Background: The current osteoporosis screening instruments are not optimized to be used among the Malaysian population. This study aimed to develop an osteoporosis screening algorithm based on risk factors for Malaysians. Methods: Malaysians aged ≥50 years (n = 607) from Klang Valley, Malaysia were interviewed and their bone health status was assessed using a dual-energy X-ray absorptiometry device. The algorithm was constructed based on osteoporosis risk factors using multivariate logistic regression and its performance was assessed using receiver operating characteristics analysis. Results: Increased age, reduced body weight and being less physically active significantly predicted osteoporosis in men, while in women, increased age, lower body weight and low-income status significantly predicted osteoporosis. These factors were included in the final algorithm and the optimal cut-offs to identify subjects with osteoporosis was 0.00120 for men [sensitivity 73.3% (95% confidence interval (CI) = 54.1%–87.7%), specificity 67.8% (95% CI = 62.7%–85.5%), area under curve (AUC) 0.705 (95% CI = 0.608–0.803), p < 0.001] and 0.161 for women [sensitivity 75.4% (95% CI = 61.9%–73.3%), specificity 74.5% (95% CI = 68.5%–79.8%), AUC 0.749 (95% CI = 0.679–0.820), p < 0.001]. Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

Subramaniam

Chan

Soelaiman

et al. 2020

IJERPH

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“…This cross-sectional study was conducted from April 2018 to April 2019 in Klang Valley, Malaysia. The protocol of the main study has been described previously [27][28][29]. Community-living Malaysian subjects aged ≥40 years were recruited using quota sampling technique, whereby subjects were stratified based on the demographic population in Klang Valley, which is 45% Malays, 45% Chinese and 10% Indians and other ethnic groups [30].…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2020

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Background: Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. Methods: The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden’s index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <−1) showed a sensitivity of 82.1% (95% CI: 77.9–85.7%), specificity of 51.5% (95% CI: 46.5–56.6%) and AUC of 0.668 (95% CI: 0.630–0.706) in identifying subjects with suboptimal bone health (DXA T-score <−1) (p < 0.001). At QUS T-score ≤−2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤−2.5) (sensitivity 14.4% (95% CI: 8.1–23.0%); specificity 96.1% (95% CI: 94.4–97.4%); AUC 0.553 (95% CI: 0.488–0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8–72.3%); specificity 72.8% (95% CI: 68.1–77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666–0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0–86.9%); specificity 61.8% (95% CI: 58.1–65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654–0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.

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Correlation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXA

Amin

Zakaria²,

Yahya

2021

Skeletal Radiol

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The performance of osteoporosis self-assessment tool for Asians (OSTA) in identifying the risk of osteoporosis among Malaysian population aged 40 years and above

Cited by 24 publications

References 33 publications

Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

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

Correlation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXA

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