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Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review

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An Erratum to this article was published on 30 June 2007

Abstract

Summary

The Osteoporosis Self-Assessment Tool (OST) is a simple test that may be of clinical value to rule-out low bone mineral density. We performed a systematic review to assess its performance in postmenopausal women. We included 36 studies. OST performed moderately in ruling-out femoral neck T-score ≤ −2.5, but poorly in ruling-out lumbar spine T-score ≤ −2.5. Methodological study quality was generally low.

Introduction

The Osteoporosis Self-Assessment Tool (OST) is a simple clinical decision rule based on age and weight that may be of clinical value to rule-out low bone mineral density (BMD). Our aim was to systematically assess the performance of OST in postmenopausal women.

Methods

We searched PubMed, Embase, Web of Science, citation lists and conference proceedings for studies evaluating OST using dual X-ray absorptiometry (DXA) as reference test to measure BMD. We evaluated methodological quality using the QUADAS checklist. Our main outcome was the likelihood ratio of a negative OST result (LR-).

Results

OST performed moderately in ruling-out femoral neck T-score ≤ −2.5 in whites, summary LR- (sLR-) 0.19 (95% CI, 0.17–0.21) and between-study heterogeneity was low (I 2 = 7%). The corresponding performance in Asians was similar, sLR- 0.19 (0.14–0.28), but there was considerable heterogeneity (I 2 = 64%). OST performed poorly in ruling-out lumbar spine T-score ≤ −2.5 in whites and Asians, sLR- 0.43 (0.31–0.59) and 0.32 (0.28–0.38), respectively. The performance in ruling-out T-score ≤ −2.0 in whites was poor regardless of region (sLR- ≥0.28). Methodological study quality was generally low.

Conclusions

The clinical usefulness of OST is uncertain. OST could be useful for ruling-out femoral neck T-score ≤ −2.5, but confirmatory high-quality studies are needed.

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Acknowledgements

We wish to thank the authors of studies included in the review who replied to our request for additional information.

Funding

The funding sources, Copenhagen Hospital Cooperation and University of Copenhagen, had no role in the study.

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Authors and Affiliations

  1. Osteoporosis Unit 545, Department of Endocrinology, Hvidovre University Hospital, Kettegaard Allé 30, 2650, Hvidovre, Denmark

    B. Rud & L. Hyldstrup

  2. Department of Biostatistics, Institute of Public Health, Faculty of Health Sciences University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen, Denmark

    J. Hilden

  3. The Nordic Cochrane Centre, Rigshospitalet 7112, Blegdamsvej 9, 2100, Copenhagen, Denmark

    A. Hróbjartsson

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  1. B. Rud
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  2. J. Hilden
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Correspondence to B. Rud.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00198-007-0420-2

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Rud, B., Hilden, J., Hyldstrup, L. et al. Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review. Osteoporos Int 18, 1177–1187 (2007). https://doi.org/10.1007/s00198-006-0319-3

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