Evaluation of Clinical Decision Rules for Bone Mineral Density Testing among White Women

Different Tools for the Assessment of Bone Mass among Egyptian Adults

BACKGROUND: Several tools such as, dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT) and self-assessment tool (OST), are being used for diagnosis of osteoporosis.OBJECTIVE: to compare the sensitivity and specify detection rate of bone mineral density (BMD) changes for DXA versus QCT and OST among a sample of Egyptian adults of both sexes.SUBJECTS AND METHODS: This study is a cross sectional one, which included 62 Egyptians, aged 20-65 years.  Each individual was assessed for BMD using DXA at femur and spine sites; QCT and OST which take into account body weight and age. Accordingly they were diagnosed as either osteoporotic/osteopenic or normal.RESULTS: The highest prevalence of osteopenia or osteoporosis was diagnosed among menopause women. DXA at femur has diagnosed more cases of osteoporosis (both osteopenic and osteoporotic) as compared to spine DXA or QCT, but OST is out of rang; as it failed to diagnose any case.CONCLUSION: DXA has been found to be more efficacious than QCT scan in the diagnosis of osteoporosis. DXA in femur is better than DXA-spine and QCT. Generally, DXA is the "gold standard" when assessing osteoporosis. Further studies are needed to modify the equation of OST and confirm its efficiency in Egyptians population.

Osteoporosis self-assessment tool performance in a large sample of postmenopausal women of mendoza, Argentina

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 (N = 1830) or nonosteoporotic (n = 2513) according to their lowest T-score at any site. Osteoporotic patients had lower OST scores (P < 0.0001). A receiver operating characteristic (ROC) curve showed an area under the curve of 71% (P < 0.0001), 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; P < 0.0001). It is concluded that the OST is useful for selecting postmenopausal women for DXA testing in the studied population.