Comparison of the Osteoporosis Self-Assessment Tool for Asians and the fracture risk assessment tool - FRAX to identify densitometric defined osteoporosis: A discriminatory value analysis in a multi-ethnic female population in Southeast Asia
| Autor: | Wan Chen Ang, Susan Logan, Sarath Lekamwasam, Manju Chandran, Sean Xuexian Yan, Donovan Tay, Yun Ann Chin, Ying Hao, Amin Ali, X. F. Huang, Kuan Swen Choo, Tin Kyaw Kyaw Aung, Win Pa Pa Thu, Xiao Ming Liu |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Self-assessment medicine.medical_specialty FRAX Asia lcsh:Diseases of the musculoskeletal system Osteoporosis Youden's J statistic Population 030209 endocrinology & metabolism Southeast asian 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine education Hip fracture education.field_of_study Receiver operating characteristic business.industry medicine.disease OSTA Screening Original Article 030101 anatomy & morphology lcsh:RC925-935 business Assessment threshold |
| Zdroj: | Osteoporosis and Sarcopenia, Vol 6, Iss 2, Pp 53-58 (2020) Osteoporosis and Sarcopenia |
| ISSN: | 2405-5255 |
| Popis: | Objectives The accuracy of FRAX® as a screening tool to identify osteoporosis and how it compares with tools such as Osteoporosis Self-Assessment Tool for Asians (OSTA), in Southeast Asian women has so far been unexplored. We aimed to determine the FRAX® thresholds that accurately identify densitometric osteoporosis and to compare its performance with that of OSTA for this purpose. Methods Singaporean postmenopausal women (n = 1056) were evaluated. FRAX® Major Osteoporotic Fracture Probability (MOFP), Hip Fracture Probability (HFP) scores, and OSTA indices were calculated. Receiver operating characteristic (ROC) curves were constructed and via the Youden index, the optimal cut-off points of balanced sensitivity and specificity for dual energy X-ray absorptiometry (DXA)-defined osteoporosis were identified and the performance characteristics were compared. Results A FRAX® MOFP threshold of ≥3.7% had sensitivity, specificity, positive predictive value and negative predictive value of 0.78 (0.73–0.83), 0.63 (0.59–0.66), 0.4 (0.36–0.44), and 0.9 (0.87–0.92), respectively in identifying osteoporosis. The corresponding values for a HFP threshold of ≥0.6% were 0.85 (0.80–0.89), 0.58 (0.55–0.62), 0.39 (0.35–0.43), and 0.92 (0.9–0.94) and that for an OSTA index cut-off of ≤ −1.2 were 0.76 (0.70–0.81), 0.74 (0.71–0.77), 0.48 (0.43–0.54), and 0.91 (0.88–0.93). The area under the ROC curves were 82.8% (79.9%–85.6%), 77.6% (74.2%–81%), and 79.6% (76.5%–82.8%) for OSTA, MOFP, and HFP thresholds respectively. Conclusions FRAX® and OSTA perform comparably in identifying osteoporosis in our population. OSTA has only 2 parameters and may be simpler to use. However, FRAX® may also have a role in primary screening to identify the postmenopausal woman to be referred for DXA scanning and may help facilitate fracture risk reduction discussions with the patient. |
| Databáze: | OpenAIRE |
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