engleski

Development and validation of the osteoporosis risk score (ORS) tool to enhance targeting women with low bone mineral density

Clinical osteoporosis prescreening tools are intended to select individuals most likely to benefit from BMD testing. This study aims to develop and validate Osteoporosis Risk Score (ORS), a new prescreening tool intended to be used in women aged 45 years and older. Two cohorts of women aged 45–87 years without previous diagnosis of osteoporosis participated in the development (n= 200) and the validation (n =1000) of the ORS tool. Data on risk factors for osteoporosis were assessed by questionnaire and BMD by DXA (Hologic Delphi C, Bedford, USA). Risk factors that best predicted Tscore≤− 2.5 at the femoral neck region were selected for inclusion into the ORS. Logistic regression analysis was used to select significant predictors of BMD, whereas receiveroperating characteristic (ROC) analysis was used to assess the discriminatory performance of the ORS tool. Validation of the ORS tool and comparison with other validated osteoporosis tools were evaluated in terms of sensitivity and specificity using the original developer’s cutoffs and densitometric target outcomes. The ORS tool was developed based on four variables: age >65 years (3 points), years post-menopause of >14 years (3 points), height < 160 cm (2 points) and weight < 73 kg (1 point). Cut-off value of > 6 points (out of 9 possible) was associated with the 80.0 % sensitivity and 81.6 % specificity to identify women with low bone mass. Applying the ORS tool among the study population(validation cohort) showed lower sensitivity (58.9 %) and higher specificity (82.1 %) compared to ORAI, ABONE, OST tools (sensitivity of 86.3 %, 83.6 %, 80.8 % and specificity of 52.5 %, 55.9 %, 58.6 %), respectively.ORS tool showed better prediction of low BMD among women above 65 years compared to group of women. The Osteoporosis Risk Score tool is a simple scoring system based on four risk factors for osteoporosis. Due to its higher specificity and somewhat lower sensitivity ORS tool showed better performance in discrimination of women in whom BMD testing is unnecessary. Further investigation is needed to determine prescreening osteoporosis scoring system among women aged 45–64 years.

(osteoporosis ; risk ; bone mineral density)

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