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Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a primary care setting.
J Am Board Fam Med. 2013 Jul-Aug; 26(4):436-44.JA

Abstract

BACKGROUND

Primary care physicians are positioned to promote early recognition and treatment of men at risk for osteoporosis-related fractures; however, efficient screening strategies are needed. This study was designed to validate the Male Osteoporosis Risk Estimation Score (MORES) for identifying men at increased risk of osteoporosis.

METHODS

This was a blinded analysis of the MORES, administered prospectively in a cross-sectional sample of men aged 60 years or older. Participants completed a research questionnaire at an outpatient visit and had a dual-energy X-ray absorptiometry (DXA) scan to assess bone density. Sensitivity, specificity, and area under-the-curve (AUC) were estimated for the MORES. Effectiveness was assessed by the number needed-to-screen (NNS) to prevent one additional major osteoporotic fracture.

RESULTS

A total of 346 men completed the study. The mean age was 70.2 ± 6.9 years; 76% were non-Hispanic white. Fifteen men (4.3%) had osteoporosis of the hip. The operating characteristics were sensitivity 0.80 (95% confidence interval [CI], 0.52-0.96); specificity 0.70 (95% CI, 0.64-0.74), and AUC of 0.82 (95% CI, 0.71-0.92). Screening with the MORES yielded a NNS to prevent one additional major osteoporotic fracture over 10 years with 259 (95% CI, 192-449) compared to 636 for universal screening with a DXA.

CONCLUSION

This study validated the MORES as an effective and efficient approach to identifying men at increased risk of osteoporosis who may benefit from a diagnostic DXA scan.

Authors+Show Affiliations

Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX 77555-1123, USA. acass@utmb.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23833159

Citation

Cass, Alvah R., and Angela J. Shepherd. "Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a Primary Care Setting." Journal of the American Board of Family Medicine : JABFM, vol. 26, no. 4, 2013, pp. 436-44.
Cass AR, Shepherd AJ. Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a primary care setting. J Am Board Fam Med. 2013;26(4):436-44.
Cass, A. R., & Shepherd, A. J. (2013). Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a primary care setting. Journal of the American Board of Family Medicine : JABFM, 26(4), 436-44. https://doi.org/10.3122/jabfm.2013.04.120182
Cass AR, Shepherd AJ. Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a Primary Care Setting. J Am Board Fam Med. 2013 Jul-Aug;26(4):436-44. PubMed PMID: 23833159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a primary care setting. AU - Cass,Alvah R, AU - Shepherd,Angela J, PY - 2013/7/9/entrez PY - 2013/7/9/pubmed PY - 2013/10/22/medline KW - Decision Making KW - Men's Health KW - Osteoporosis KW - Prevention KW - Primary Health Care KW - Screening SP - 436 EP - 44 JF - Journal of the American Board of Family Medicine : JABFM JO - J Am Board Fam Med VL - 26 IS - 4 N2 - BACKGROUND: Primary care physicians are positioned to promote early recognition and treatment of men at risk for osteoporosis-related fractures; however, efficient screening strategies are needed. This study was designed to validate the Male Osteoporosis Risk Estimation Score (MORES) for identifying men at increased risk of osteoporosis. METHODS: This was a blinded analysis of the MORES, administered prospectively in a cross-sectional sample of men aged 60 years or older. Participants completed a research questionnaire at an outpatient visit and had a dual-energy X-ray absorptiometry (DXA) scan to assess bone density. Sensitivity, specificity, and area under-the-curve (AUC) were estimated for the MORES. Effectiveness was assessed by the number needed-to-screen (NNS) to prevent one additional major osteoporotic fracture. RESULTS: A total of 346 men completed the study. The mean age was 70.2 ± 6.9 years; 76% were non-Hispanic white. Fifteen men (4.3%) had osteoporosis of the hip. The operating characteristics were sensitivity 0.80 (95% confidence interval [CI], 0.52-0.96); specificity 0.70 (95% CI, 0.64-0.74), and AUC of 0.82 (95% CI, 0.71-0.92). Screening with the MORES yielded a NNS to prevent one additional major osteoporotic fracture over 10 years with 259 (95% CI, 192-449) compared to 636 for universal screening with a DXA. CONCLUSION: This study validated the MORES as an effective and efficient approach to identifying men at increased risk of osteoporosis who may benefit from a diagnostic DXA scan. SN - 1558-7118 UR - https://www.unboundmedicine.com/medline/citation/23833159/Validation_of_the_Male_Osteoporosis_Risk_Estimation_Score__MORES__in_a_primary_care_setting_ L2 - http://www.jabfm.org/cgi/pmidlookup?view=long&pmid=23833159 DB - PRIME DP - Unbound Medicine ER -