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Article: Comparison of a simple clinical risk index and quantitative bone ultrasound for identifying women at increased risk of osteoporosis

TitleComparison of a simple clinical risk index and quantitative bone ultrasound for identifying women at increased risk of osteoporosis
Authors
Issue Date2003
PublisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198
Citation
Osteoporosis International, 2003, v. 14 n. 9, p. 716-721 How to Cite?
AbstractOsteoporosis is a growing problem in Asia, and early identification of at risk subjects for preventive measures is likely the most cost-effective method for managing this disease in developing countries. Patients with low bone mineral density (BMD) have a high risk of future fracture. However, access to BMD measurements is limited in many areas of Asia, and inexpensive methods of targeting high-risk patients for BMD measurements would be valuable. We compared two methods, a simple clinical risk assessment tool, the Osteoporosis Self-assessment Tool for Asians (OSTA), and quantitative bone ultrasound (QUS) in identifying subjects with low BMD by DXA in 722 southern Chinese postmenopausal women recruited from the community in Hong Kong. Using the published cutoff value of -1 (versus 0 or higher) for OSTA to identify subjects with femoral neck BMD T-score ≤ -2.5, basing on our local population peak young mean value, the sensitivity and specificity was 88% and 54% respectively. The optimal cutoff T-score of -2.35 for QUS yielded sensitivity and specificity values of 81% and 65%, respectively. The AUC for QUS was 0.78, which was not significantly different from that of 0.80 for OSTA. Both OSTA and QUS correlated significantly with BMD at the femoral neck (0.62 and 0.36, respectively, P both < 0.001). When these cut-off values were used to identify subjects with either lumbar spine or femoral neck BMD T-score ≤ -2.5, the sensitivity and specificity was 79% and 60%, respectively, for OSTA, and 69% and 70%, respectively, for QUS. Combining QUS with OSTA improved the sensitivity to 91%, but the specificity was reduced to 44%. We conclude that the simple clinical risk assessment tool OSTA is a free and effective method for identifying subjects at increased risk of osteoporosis, and its use could facilitate the appropriate and more cost-effective use of bone densitometry in developing countries.
Persistent Identifierhttp://hdl.handle.net/10722/77065
ISSN
2015 Impact Factor: 3.445
2015 SCImago Journal Rankings: 1.460
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorHo, AYYen_HK
dc.contributor.authorSedrine, WBen_HK
dc.contributor.authorReginster, JYen_HK
dc.contributor.authorRoss, PDen_HK
dc.date.accessioned2010-09-06T07:27:53Z-
dc.date.available2010-09-06T07:27:53Z-
dc.date.issued2003en_HK
dc.identifier.citationOsteoporosis International, 2003, v. 14 n. 9, p. 716-721en_HK
dc.identifier.issn0937-941Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/77065-
dc.description.abstractOsteoporosis is a growing problem in Asia, and early identification of at risk subjects for preventive measures is likely the most cost-effective method for managing this disease in developing countries. Patients with low bone mineral density (BMD) have a high risk of future fracture. However, access to BMD measurements is limited in many areas of Asia, and inexpensive methods of targeting high-risk patients for BMD measurements would be valuable. We compared two methods, a simple clinical risk assessment tool, the Osteoporosis Self-assessment Tool for Asians (OSTA), and quantitative bone ultrasound (QUS) in identifying subjects with low BMD by DXA in 722 southern Chinese postmenopausal women recruited from the community in Hong Kong. Using the published cutoff value of -1 (versus 0 or higher) for OSTA to identify subjects with femoral neck BMD T-score ≤ -2.5, basing on our local population peak young mean value, the sensitivity and specificity was 88% and 54% respectively. The optimal cutoff T-score of -2.35 for QUS yielded sensitivity and specificity values of 81% and 65%, respectively. The AUC for QUS was 0.78, which was not significantly different from that of 0.80 for OSTA. Both OSTA and QUS correlated significantly with BMD at the femoral neck (0.62 and 0.36, respectively, P both < 0.001). When these cut-off values were used to identify subjects with either lumbar spine or femoral neck BMD T-score ≤ -2.5, the sensitivity and specificity was 79% and 60%, respectively, for OSTA, and 69% and 70%, respectively, for QUS. Combining QUS with OSTA improved the sensitivity to 91%, but the specificity was reduced to 44%. We conclude that the simple clinical risk assessment tool OSTA is a free and effective method for identifying subjects at increased risk of osteoporosis, and its use could facilitate the appropriate and more cost-effective use of bone densitometry in developing countries.en_HK
dc.languageengen_HK
dc.publisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198en_HK
dc.relation.ispartofOsteoporosis Internationalen_HK
dc.subject.meshAbsorptiometry, Photonen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshBone Densityen_HK
dc.subject.meshBone and Bones - ultrasonographyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFemur Neck - physiopathologyen_HK
dc.subject.meshFractures, Bone - etiology - prevention & controlen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLumbar Vertebrae - physiopathologyen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshOsteoporosis, Postmenopausal - complications - ethnology - ultrasonographyen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshSensitivity and Specificityen_HK
dc.titleComparison of a simple clinical risk index and quantitative bone ultrasound for identifying women at increased risk of osteoporosisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0937-941X&volume=14&spage=716&epage=21&date=2003&atitle=Comparison+of+a+simple+clinical+risk+index+and+quantitative+bone+ultrasound+for+identifying+women+at+increased+risk+of+osteoporosisen_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00198-003-1428-xen_HK
dc.identifier.pmid12897978-
dc.identifier.scopuseid_2-s2.0-0142086877en_HK
dc.identifier.hkuros87820en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0142086877&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue9en_HK
dc.identifier.spage716en_HK
dc.identifier.epage721en_HK
dc.identifier.isiWOS:000185460100002-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridHo, AYY=7402675209en_HK
dc.identifier.scopusauthoridSedrine, WB=6603203113en_HK
dc.identifier.scopusauthoridReginster, JY=35378176800en_HK
dc.identifier.scopusauthoridRoss, PD=7402412920en_HK

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