Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2016; 7(9): 577-583
Published online Sep 18, 2016. doi: 10.5312/wjo.v7.i9.577
Risk assessment instruments for screening bone mineral density in a Mediterranean population
Sotirios Christodoulou, Georgios I Drosos, Athanasios Ververidis, Antonios Galanos, George Anastassopoulos, Konstantinos Kazakos
Sotirios Christodoulou, Georgios I Drosos, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
Antonios Galanos, Laboratory for Research of the Musculoskeletal System, University of Athens, KAT Hospital, Kifissia, 14561 Athens, Greece
George Anastassopoulos, Medical Informatics Laboratory, Medical School, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece
Author contributions: Christodoulou S drafted the manuscript; Drosos GI and Ververidis A participated in study design and edited the manuscript; Galanos A and Anastasopoulos G performed data analysis; Kazakos K provided oversight to manuscript development, recruited patients, and collected data; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Democritus University of Thrace Medical Institutional Review Boards.
Informed consent statement: All study participants provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Georgios I Drosos, MD, PhD, Associate Professor of Orthopaedics, Department of Orthopaedic Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, St. Niarhos Street 1, Dragana, 68100 Alexandroupolis, Greece. drosos@otenet.gr
Telephone: +30-6944-380694 Fax: +30-25510-30370
Received: March 27, 2016
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
Abstract
AIM

To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.

METHODS

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.

RESULTS

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.

CONCLUSION

Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.

Keywords: Osteoporosis, Bone mineral density, Risk assessment, Dual X-ray absorptiometry, Osteopenia

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.