Comparison of the Male Osteoporosis Risk Estimation Score (MORES) With FRAX in Identifying Men at Risk for Osteoporosis
| Autor: | Angela J. Shepherd, Manju Mahajan, Maimoona Nizami, Alvah R. Cass, Rechelle Asirot |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty FRAX National Health and Nutrition Examination Survey Osteoporosis Population 030209 endocrinology & metabolism Standard score Risk Assessment Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Absorptiometry Photon Bone Density Internal medicine medicine Humans Mass Screening 030212 general & internal medicine education Mass screening Femoral neck Aged education.field_of_study business.industry Area under the curve Methodology Middle Aged medicine.disease Nutrition Surveys medicine.anatomical_structure Cross-Sectional Studies Family Practice business |
| Zdroj: | Annals of family medicine. 14(4) |
| ISSN: | 1544-1717 |
| Popis: | PURPOSE We wanted to compare the male osteoporosis risk estimation score (MORES) with the fracture risk assessment tool (FRAX) in screening men for osteoporosis. METHODS This study reports analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III), a nationally representative sample of the US population, comparing the operating characteristics of FRAX and MORES to identify men at risk for osteoporosis using a subset of 1,498 men, aged 50 years and older, with a valid dual-energy x-ray absorptiometry (DXA) scan. DXA-derived bone mineral density using a T score of −2.5 or lower at either the femoral neck or total hip defined the diagnosis of osteoporosis. Outcomes included the operating characteristics, area under the receiver-operator characteristic curve, and agreement of the FRAX and MORES. RESULTS Sixty-seven (4.5%) of the 1,498 men had osteoporosis of the hip. The sensitivity, specificity, and area under the curve (AUC) for the MORES were 0.96 (95% CI, 0.87–0.99), 0.61 (95% CI, 0.58–0.63), and 0.87 (95% CI, 0.84–0.91), respectively. The sensitivity, specificity, and AUC for the FRAX were 0.39 (95% CI, 0.27–0.51), 0.89 (95% CI, 0.88–0.91), and 0.79 (95% CI, 0.75–0.84) respectively. Agreement was poor. CONCLUSIONS Compared with the MORES, the FRAX underperformed as a screening strategy for osteoporosis using the threshold score suggested by the US Preventive Services Task Force (USPSTF). An integrated approach that uses the MORES to determine which men should have a DXA scan and the FRAX to guide treatment decisions, based on the risk of a future fracture, identified 82% of men who were candidates for treatments based on National Osteoporosis Foundation guidelines. |
| Databáze: | OpenAIRE |
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