The Osteoporosis Self-Assessment Tool versus alternative tests for selecting postmenopausal women for bone mineral density assessment: a comparative systematic review of accuracy
- PMID: 18716823
- DOI: 10.1007/s00198-008-0713-0
The Osteoporosis Self-Assessment Tool versus alternative tests for selecting postmenopausal women for bone mineral density assessment: a comparative systematic review of accuracy
Abstract
Summary: We performed a systematic review of studies comparing the Osteoporosis Self-Assessment Tool (OST) and other tests used to select women for bone mineral density (BMD) assessment. In comparative meta-analyses, we found that the accuracy of OST was similar to other tests that are based on information from the medical history. By contrast, assessment by quantitative ultrasonography at the heel was more accurate than OST in discriminating between women with high and low BMD. The methodological quality of the included studies was generally low.
Introduction: Numerous tests are suggested for triaging postmenopausal women for bone mineral density (BMD) assessment by dual-energy X-ray absorptiometry. Previous studies suggest that OST, based on age and weight only, may be as accurate as more complex triage tests. We systematically compare the accuracy of OST and alternative triage tests in postmenopausal women.
Methods: We searched PubMed, Embase, Web of Science, citation lists, and conference proceedings. Our main measure of accuracy was the diagnostic odds ratio (DOR). We compared summary estimates of DOR (sDOR) for OST and alternative tests in pairwise meta-analyses by using the Moses-Littenberg approach.
Results: Summary estimates of DOR for OST and the clinical decision rules Simple Calculated Osteoporosis Risk Estimation (SCORE) and Osteoporosis Risk Assessment Instrument (ORAI) did not differ significantly in white women (relative sDOR: 0.57-1.17, all p >or= 0.11). By contrast, sDOR was higher for Stiffness Index assessed by calcaneal quantitative ultrasonography than for OST (relative sDOR: 1.9, p = 0.005). Studies were few in Asian and black women. Methodological quality, assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist, was generally low.
Conclusions: In white women, the accuracy of OST and alternative clinical decision rules was similar, whereas Stiffness Index was more accurate than OST. Low study quality renders transferability to clinical settings uncertain.
Similar articles
-
Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review.Osteoporos Int. 2007 Sep;18(9):1177-87. doi: 10.1007/s00198-006-0319-3. Epub 2007 Mar 15. Osteoporos Int. 2007. PMID: 17361324 Review.
-
Decision rules for selecting women for bone mineral density testing: application in postmenopausal women referred to a bone densitometry unit.J Rheumatol. 2007 Jun;34(6):1307-12. J Rheumatol. 2007. PMID: 17552058
-
Discriminatory Performance of the Calcaneal Quantitative Ultrasound and Osteoporosis Self-Assessment Tool to Select Older Women for Dual-Energy X-ray Absorptiometry.J Clin Densitom. 2015 Apr-Jun;18(2):157-64. doi: 10.1016/j.jocd.2015.02.006. J Clin Densitom. 2015. PMID: 25937306
-
The validity of decision rules for selecting women with primary osteoporosis for bone mineral density testing.Osteoporos Int. 2004 May;15(5):361-6. doi: 10.1007/s00198-003-1552-7. Epub 2004 Jan 17. Osteoporos Int. 2004. PMID: 14730421
-
Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density.Osteoporos Int. 2015 May;26(5):1543-54. doi: 10.1007/s00198-015-3025-1. Epub 2015 Feb 3. Osteoporos Int. 2015. PMID: 25644147 Free PMC article. Review.
Cited by
-
Molecular Subtype Classification of Postmenopausal Osteoporosis and Immune Infiltration Microenvironment Based on Bioinformatics Analysis of Osteoclast-Regulatory Genes.Biomedicines. 2023 Oct 4;11(10):2701. doi: 10.3390/biomedicines11102701. Biomedicines. 2023. PMID: 37893075 Free PMC article.
-
Osteoporosis Pre-Screening Using Ensemble Machine Learning in Postmenopausal Korean Women.Healthcare (Basel). 2022 Jun 14;10(6):1107. doi: 10.3390/healthcare10061107. Healthcare (Basel). 2022. PMID: 35742158 Free PMC article.
-
Application of Machine Learning to Identify Clinically Meaningful Risk Group for Osteoporosis in Individuals Under the Recommended Age for Dual-Energy X-Ray Absorptiometry.Calcif Tissue Int. 2021 Dec;109(6):645-655. doi: 10.1007/s00223-021-00880-x. Epub 2021 Jun 30. Calcif Tissue Int. 2021. PMID: 34195852
-
Beijing Friendship Hospital Osteoporosis Self-Assessment Tool for Elderly Male (BFH-OSTM) vs Fracture Risk Assessment Tool (FRAX) for identifying painful new osteoporotic vertebral fractures in older Chinese men: a cross-sectional study.BMC Musculoskelet Disord. 2021 Jun 28;22(1):596. doi: 10.1186/s12891-021-04476-2. BMC Musculoskelet Disord. 2021. PMID: 34182964 Free PMC article.
-
Comparison of OSTA, FRAX and BMI for Predicting Postmenopausal Osteoporosis in a Han Population in Beijing: A Cross Sectional Study.Clin Interv Aging. 2020 Jul 17;15:1171-1180. doi: 10.2147/CIA.S257166. eCollection 2020. Clin Interv Aging. 2020. PMID: 32764904 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
