%0 Journal Article
%T Osteoporosis Self-Assessment Tool Performance in a Large Sample of Postmenopausal Women of Mendoza, Argentina
%A Fernando D. Sarav¨ª
%J Journal of Osteoporosis
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/150154
%X The Osteoporosis Self-assessment Tool (OST) is a clinical instrument designed to select patients at risk of osteoporosis, who would benefit from a bone mineral density measurement. The OST only takes into account the age and weight of the subject. It was developed for Asian women and later validated for European and North American white women. The performance of the OST in a sample of 4343 women from Greater Mendoza, a large metropolitan area of Argentina, was assessed. Dual X-ray absorptiometry (DXA) scans of lumbar spine and hip were obtained. Patients were classified as either osteoporotic ( ) or nonosteoporotic ( ) according to their lowest T-score at any site. Osteoporotic patients had lower OST scores ( ). A receiver operating characteristic (ROC) curve showed an area under the curve of 71% ( ), with a sensitivity of 83.7% and a specificity of 44% for a cut-off value of 2. Positive predictive value was 52% and negative predictive value was 79%. The odds ratio for the diagnosis of osteoporosis was 4.06 (CI95 3.51 to 4.71; ). It is concluded that the OST is useful for selecting postmenopausal women for DXA testing in the studied population. 1. Introduction Osteoporosis is a systemic skeletal disorder characterized by low bone strength (arising from both low bone mass and microarchitectural deterioration), which increases the risk of fractures. Osteoporosis is a major public health problem and an important contributor to the global burden of noncommunicable disease [1]. Currently the recommended method for the diagnosis of osteoporosis is bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) [2]. According to the World Health Organization criteria, osteoporosis is operationally defined ¡°as a BMD that lies 2.5 standard deviations or more below the average value for young healthy women.¡± [2]. Since, due to cost and availability, DXA scans are not recommended for screening purposes, several tools based on known clinical risk factors have been developed to identify those patients with high risk of osteoporosis, in whom actual BMD testing would be most useful in terms of diagnosis, treatment, and followup [3, 4]. Some of these clinical tools, or aids in decision making, include many factors, making calculation of risk cumbersome [5, 6]. Arguably the simplest decision rule is the Osteoporosis Self-assessment Tool (OST) which only takes into account body weight and age, which in adult populations are, respectively, related inversely and directly to the risk of osteoporosis [7]. The OST was developed for predicting risk of femoral
%U http://www.hindawi.com/journals/jos/2013/150154/