Abstract
Summary
No large-scale evaluations of osteoporosis screening tools have been done in men. OST and MOST were examined among 4658 US Caucasian and 1914 Hong Kong Chinese men. Both tools have high negative predictive values, accurately screening out men with low risk, and saving a third of DXA tests.
Introduction
Prior investigations have studied the performance of osteoporosis screening tools in women, but no large-scale evaluations have been done in men.
Methods
This study examines the performance of the Osteoporosis Self-assessment Tool (OST), the Male Osteoporosis Screening Tool (MOST), quantitative ultrasound index (QUI), and body weight as screening tools. Osteoporosis was defined by a dual-energy X-ray absorptiometry (DXA) measured bone mineral density (BMD) T-score ≤−2.5. Four thousand six hundred and fifty-eight US Caucasian and 1914 Hong Kong Chinese men, aged ≥65 years and community-dwelling, were included in the analysis. Receiver operating characteristic (ROC) analysis was used to compare the area under the ROC curve (AUC) between different screening tools.
Results
MOST had a significantly larger AUC (≥0.8) than OST, QUI, and body weight in detecting osteoporosis. Using the second tertile as cutoff, OST and MOST yielded sensitivities of around 90% and negative predictive values (NPVs) of >97%, accurately screening out Caucasian and Chinese men with low risk of osteoporosis.
Conclusions
OST and MOST can effectively rule out osteoporosis for both Caucasian and Chinese men, and compared to referring men 65 years and older for BMD DXA testing, they save a third of DXA resources.
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Acknowledgment
The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provided support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, and UL1 RR024140. Support for the study on Hong Kong subjects came from the Hong Kong Research Grants Council Earmarked grant CUHK4101/02M, and the NIAMS grant R01 AR49439. The authors wish to thank all the participants for their dedicated contribution to the study.
Conflicts of interest
Dr. Cauley has received research support from Merck & Company, Eli Lilly & Company, Pfizer Pharmaceuticals and Novartis Pharmaceuticals. She has also received consulting fees from Eli Lilly & Company, and Novartis Pharmaceuticals. She is on the speaker’s bureau for Merck & Co., Inc.
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Lynn, H.S., Woo, J., Leung, P.C. et al. An evaluation of osteoporosis screening tools for the osteoporotic fractures in men (MrOS) study. Osteoporos Int 19, 1087–1092 (2008). https://doi.org/10.1007/s00198-007-0553-3
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DOI: https://doi.org/10.1007/s00198-007-0553-3