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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.JR

Abstract

OBJECTIVE

Although several decision rules have been developed to identify postmenopausal women who may be selected for dual-energy x-ray absorptiometry measurements, information on their utility in a clinical setting is scarce. We evaluated the utility of 4 previously validated decision rules in a large group of Spanish postmenopausal women referred to a bone densitometry unit.

METHODS

We reviewed the data on 665 postmenopausal women (mean age 54.2 +/- 5.4 yrs). We selected the 4 decision rules that could be applied with the information that was available: the Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Self-Assessment Tool (OST), Osteoporosis Index of Risk (OSIRIS), and Body Weight Criterion (BWC). The sensitivity, specificity, and predictive values of each decision rule were determined.

RESULTS

The ORAI would recommend 45% of women for bone mineral density (BMD) testing, OST 46%, OSIRIS 37%, and BWC 70%. Sensitivity values obtained in the overall series were 64.1% for the ORAI, 69.2% for OST, 58.1% for OSIRIS, and 83.8% for BWC. The sensitivity increased progressively with age. The negative predictive value in the overall series was 88.5% for ORAI, 89.9% for OST, 88.4% for OSIRIS, and 90.6% for BWC.

CONCLUSION

In a complementary way with previous studies in older women, where decision rules were valuable to identify the majority of women likely to have osteoporosis, our data indicate that in younger postmenopausal women, decision rules are useful as a screening method to rule out the presence of osteoporosis and the need for BMD scanning.

Authors+Show Affiliations

Rheumatology Department, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17552058

Citation

Martínez-Aguilà, Dolors, et al. "Decision Rules for Selecting Women for Bone Mineral Density Testing: Application in Postmenopausal Women Referred to a Bone Densitometry Unit." The Journal of Rheumatology, vol. 34, no. 6, 2007, pp. 1307-12.
Martínez-Aguilà D, Gómez-Vaquero C, Rozadilla A, et al. Decision rules for selecting women for bone mineral density testing: application in postmenopausal women referred to a bone densitometry unit. J Rheumatol. 2007;34(6):1307-12.
Martínez-Aguilà, D., Gómez-Vaquero, C., Rozadilla, A., Romera, M., Narváez, J., & Nolla, J. M. (2007). Decision rules for selecting women for bone mineral density testing: application in postmenopausal women referred to a bone densitometry unit. The Journal of Rheumatology, 34(6), 1307-12.
Martínez-Aguilà D, et al. Decision Rules for Selecting Women for Bone Mineral Density Testing: Application in Postmenopausal Women Referred to a Bone Densitometry Unit. J Rheumatol. 2007;34(6):1307-12. PubMed PMID: 17552058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decision rules for selecting women for bone mineral density testing: application in postmenopausal women referred to a bone densitometry unit. AU - Martínez-Aguilà,Dolors, AU - Gómez-Vaquero,Carmen, AU - Rozadilla,Antoni, AU - Romera,Montserrat, AU - Narváez,Javier, AU - Nolla,Joan M, PY - 2007/6/7/pubmed PY - 2007/8/31/medline PY - 2007/6/7/entrez SP - 1307 EP - 12 JF - The Journal of rheumatology JO - J Rheumatol VL - 34 IS - 6 N2 - OBJECTIVE: Although several decision rules have been developed to identify postmenopausal women who may be selected for dual-energy x-ray absorptiometry measurements, information on their utility in a clinical setting is scarce. We evaluated the utility of 4 previously validated decision rules in a large group of Spanish postmenopausal women referred to a bone densitometry unit. METHODS: We reviewed the data on 665 postmenopausal women (mean age 54.2 +/- 5.4 yrs). We selected the 4 decision rules that could be applied with the information that was available: the Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Self-Assessment Tool (OST), Osteoporosis Index of Risk (OSIRIS), and Body Weight Criterion (BWC). The sensitivity, specificity, and predictive values of each decision rule were determined. RESULTS: The ORAI would recommend 45% of women for bone mineral density (BMD) testing, OST 46%, OSIRIS 37%, and BWC 70%. Sensitivity values obtained in the overall series were 64.1% for the ORAI, 69.2% for OST, 58.1% for OSIRIS, and 83.8% for BWC. The sensitivity increased progressively with age. The negative predictive value in the overall series was 88.5% for ORAI, 89.9% for OST, 88.4% for OSIRIS, and 90.6% for BWC. CONCLUSION: In a complementary way with previous studies in older women, where decision rules were valuable to identify the majority of women likely to have osteoporosis, our data indicate that in younger postmenopausal women, decision rules are useful as a screening method to rule out the presence of osteoporosis and the need for BMD scanning. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/17552058/Decision_rules_for_selecting_women_for_bone_mineral_density_testing:_application_in_postmenopausal_women_referred_to_a_bone_densitometry_unit_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=17552058 DB - PRIME DP - Unbound Medicine ER -