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Risk Assessment Tools for Osteoporosis Screening in Postmenopausal Women: A Systematic Review

Current Osteoporosis Reports volume 13, pages 287–301 (2015)Cite this article

Abstract

Osteoporotic fractures are common in postmenopausal women. Tools are available to estimate the risk of low bone mineral density (BMD) or fracture. This systematic review retrieved articles that evaluated osteoporosis risk assessment tools among postmenopausal women in North America. For identifying BMD T-score ≤−2.5, most studies of the Simple Calculated Osteoporosis Risk Estimation tool (SCORE) and Osteoporosis Risk Assessment Instrument (ORAI) reported sensitivity ≥90 %. Area under the receiver operating characteristic curve (AUC) was usually <0.75 for SCORE and ≥0.75 for ORAI. Among women 50–64 years old, a Fracture Risk Assessment Tool (FRAX) threshold ≥9.3 % had a sensitivity of 33 % for identifying BMD T-score ≤−2.5 and 26 % for predicting major osteoporotic fracture (MOF). For predicting MOF, sensitivity was higher for SCORE and Osteoporosis Self-assessment Tool equation (OST), and higher in women ≥65 years old. For predicting BMD T-score ≤−2.5 in women ≥65 years old, the sensitivities of SCORE; ORAI; and Age, Body Size, No Estrogen (ABONE) were very high. No optimal osteoporosis risk assessment tool is available for identifying low BMD and MOF risk.

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Fig. 1

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. David Geffen School of Medicine, University of California, Los Angeles, UCLA Medicine/GIM, 911 Broxton Ave., 1st floor, Los Angeles, CA, 90024, USA

    Carolyn J. Crandall

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Crandall, C.J. Risk Assessment Tools for Osteoporosis Screening in Postmenopausal Women: A Systematic Review. Curr Osteoporos Rep 13, 287–301 (2015). https://doi.org/10.1007/s11914-015-0282-z

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Keywords

  • Osteoporosis
  • Fracture
  • Bone density
  • Fracture Risk Assessment Tool (FRAX)
  • Simple Calculated Osteoporosis Risk Estimation tool (SCORE)
  • Osteoporosis Risk Assessment Instrument (ORAI)
  • Age, Body Size, No Estrogen (ABONE)
  • Osteoporosis Self-assessment Tool equation (OST)