Journal of General Internal Medicine

, Volume 20, Issue 3, pp 245–250

A risk assessment tool (OsteoRisk) for identifying latin American women with osteoporosis

Authors

    • Merck & Company, Inc.
  • Vincent P. Rives
    • Temple University School of Pharmacy
  • Osvaldo D. Messina
    • Department of RheumatologyC. Argerich Hospital
  • Jorge Morales-Torres
    • Facultad de Medicina de LeonHospital Aranda de la Parra
  • Gregorio Riera
    • Department of MedicineUniversidad de Carabobo
  • Juan M. Angulo-Solimano
    • Hospital Central de la Fuerza Aérea
  • João F. M. Neto
    • Department of RheumatologyState University (Unicamp)
  • Alberto FrisoliJr.
    • Department of Internal MedicineUniversida de Federal de Sao Paulo
  • Ricardo C. Sáenz
    • Department of Medicine, Division of RheumatologyHospital Dr. R.A. Calderón Guardia
  • Olga Geling
    • Rutgers University
  • Philip D. Ross
    • Merck Research Laboratoires
Original Articles

DOI: 10.1111/j.1525-1497.2005.40900.x

Cite this article as:
Sen, S.S., Rives, V.P., Messina, O.D. et al. J GEN INTERN MED (2005) 20: 245. doi:10.1111/j.1525-1497.2005.40900.x

Abstract

OBJECTIVE: To develop a simple and easy-to-use tool for identifying osteoporotic women (femoral neck bone mineral density [BMD] T-scores ≤−2.5) in Latin America.

DESIGN: Retrospective study involving review of medical records.

SETTING: Osteoporosis clinics in 6 Latin American countries.

PATIENTS: Postmenopausal women ages ≥50 in Latin America who had femoral neck BMD measurements.

MEASUREMENTS AND MAIN RESULTS: A risk index was developed from 1.547 patients based on least square regression using age, weight, history of fractures, and other variables as predictors for BMD T-score. The final model was simplified by reducing the number of predictors; sensitivity and specificity were evaluated before and after reducing the number of predictors to assess performance of the index. The final model included age, weight, country, estrogen use, and history of fractures as significant predictors for T-score. The resulting scoring index achieved 91% sensitivity and 47% specificity. Simplifying the index by using only age and weight yielded similar performance (sensitivity, 92%; specificity, 45%). Three risk categories were identified based on OsteoRisk, the index using only age and body weight: high-risk patients (index <=−2; 65.6% were osteoporotic), moderate-risk patients (−2<index <=1; 26.7% were osteoporotic), and low-risk patients (index>1; 8% were osteoporotic). Similar results were seen in a validation sample of 279 women in Brazil.

CONCLUSION: Age and weight alone performed well for predicting the risk of osteoporosis among postmenopausal women. The OsteoRisk is an easy-to-use tool that effectively targets the vast majority of osteoporotic patients in Latin America for evaluation with BMD.

Key words

osteoporosisbone mineral densityrisk assessment

Copyright information

© Society of General Internal Medicine 2005