The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

Autor:	Chin-Yi Chan, Nor Aini Jamil, Noorazah Abd Aziz, Shaanthana Subramaniam, Ima Nirwana Soelaiman, Fairus Ahmad, Kok-Yong Chin, Norliza Muhammad, Pei Yuen Ng, Norazlina Mohamed
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	medicine.medical_specialty Clinical Biochemistry Osteoporosis specificity 030209 endocrinology & metabolism bone Article 03 medical and health sciences 0302 clinical medicine quantitative ultrasound Malaysian population Internal medicine medicine Osteoporosis risk 030212 general & internal medicine Dual-energy X-ray absorptiometry lcsh:R5-920 dual-energy x-ray absorptiometry Receiver operating characteristic medicine.diagnostic_test business.industry Area under the curve medicine.disease sensitivity Quantitative ultrasound Osteopenia business lcsh:Medicine (General)
Zdroj:	Diagnostics, Vol 10, Iss 4, p 178 (2020) Diagnostics Volume 10 Issue 4
ISSN:	2075-4418
Popis:	Background: Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. Methods: The bone health status of Malaysians aged &ge 40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden&rsquo s index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score < &minus 1) showed a sensitivity of 82.1% (95% CI: 77.9&ndash 85.7%), specificity of 51.5% (95% CI: 46.5&ndash 56.6%) and AUC of 0.668 (95% CI: 0.630&ndash 0.706) in identifying subjects with suboptimal bone health (DXA T-score < 1) (p < 0.001). At QUS T-score &le 2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score &le 2.5) (sensitivity 14.4% (95% CI: 8.1&ndash 23.0%) specificity 96.1% (95% CI: 94.4&ndash 97.4%) AUC 0.553 (95% CI: 0.488&ndash 0.617) p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8&ndash 72.3%) specificity 72.8% (95% CI: 68.1&ndash 77.2%) J = 0.405 AUC 0.702 (95% CI: 0.666&ndash 0.739) p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0&ndash 86.9%) specificity 61.8% (95% CI: 58.1&ndash 65.5%) J = 0.412 AUC 0.706 (95% CI: 0.654&ndash 0.758) 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.
Databáze:	OpenAIRE
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