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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/2627

Title: Performance of risk indices for identifying low bone density in postmenopausal women
Authors: GEUSENS, Piet
Hochberg, MC
van der Voort, DJM
Pols, H
van der Klift, M
Siris, E
Melton, ME
Turpin, J
Byrnes, C
Ross, PD
Issue Date: 2002
Citation: MAYO CLINIC PROCEEDINGS, 77(7). p. 629-637
Abstract: Objective: To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. Subjects and Methods: Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in the Netherlands (age range, 50-80 years), women in the Rotterdam Study (the Netherlands) 55 years and older, and women aged 55 to 81 years old, screened for a clinical trial of alendronate. Bone mineral density (BMD) was measured at the femoral neck or lumbar spine; T scores represent the number of SDs below the mean for young healthy women. One risk index was calculated from age and weight; the other risk indices included up to 4 additional variables obtained by questionnaire. We calculated the sensitivity and specificity for identifying women with BMD T scores of -2.5 or less or -2.0 or less in the US clinic sample and created 3 risk categories, using each of the 4 indices. Results: Data were available for 1102 women from the US clinic sample, 3374 women in the Rotterdam Study, 23,833 women screened for a clinical trial of alendronate, and 4204 women from general practice centers in the Netherlands. Specificity for identifying BMD T scores of -2.5 or less ranged from 37% to 58% (depending on risk index) when sensitivity was approximately 90%. The prevalence of osteoporosis (defined, as T scores less than or equal to-2.5) differed widely. across the 3 risk categories, ranging from 2% to 4% for the low-risk category to 47% to 61% for the high-risk category in the US clinic sample. For spine BMD in the US clinic sample, the prevalence of T scores of -2.5 or less ranged from 7% (low risk) to 38% (high risk). The large differences in prevalence across risk categories were consistent across the other 3 samples of postmenopausal women in the United States and the Netherlands for all 4 risk indices. Conclusions: We recommend measuring BMD in women who are classified as having an increased risk of osteoporosis by using any of these risk indices because all 4 indices appear to predict low bone mass equally well. The Osteoporosis Self-assessment Tool index is easiest to calculate and therefore may be most useful in clinical practice.
Notes: Merck Res Labs, Rahway, NJ 07065 USA. Univ Limburg, Biomed Res Inst, Diepenbeek, Belgium. Univ Maastricht, Dept Rheumatol, Maastricht, Netherlands. Univ Maryland, Div Rheumatol, Baltimore, MD 21201 USA. Erasmus Univ, Sch Med, Dept Epidemiol & Biostat, NL-3000 DR Rotterdam, Netherlands. Erasmus Univ, Sch Med, Dept Internal Med, NL-3000 DR Rotterdam, Netherlands. Columbia Univ Coll Phys & Surg, Dept Med, New York, NY 10032 USA. Toni Stabile Ctr Prevent & Treatment Osteoporosis, New York, NY USA.Ross, PD, Merck Res Labs, 126 E Lincoln Ave,RY34B-172, Rahway, NJ 07065 USA.
URI: http://hdl.handle.net/1942/2627
Link to publication: http://www.mayoclinicproceedings.com/Abstract.asp?AID=129&Abst=Abstract&UID=
ISI #: 000176630300006
ISSN: 0025-6196
Category: A1
Type: Journal Contribution
Validation: ecoom, 2003
Appears in Collections: Research publications

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