Published online Sep 18, 2016. doi: 10.5312/wjo.v7.i9.577
Peer-review started: March 30, 2016
First decision: May 13, 2016
Revised: June 1, 2016
Accepted: July 14, 2016
Article in press: July 18, 2016
Published online: September 18, 2016
To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.
Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry (DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.
The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve (AUC) of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%, with a cut-off point of -2.9.
Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.
Core tip: Bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DEXA) is currently the most widely used method for osteoporosis screening, treatment and patient monitoring. Nevertheless, performing routine BMD measurements of all women is not feasible for most populations, and at present there is no universally accepted policy for population screening in Europe to identify patients with osteoporosis or those at high risk of fracture. Osteoporosis risk factor screening tools have been developed to identify postmenopausal women in need of DEXA screening and possible intervention for osteoporosis.