مرکز منطقه ای اطلاع رساني علوم و فناوري -

چكيده لاتين :

Risk indices have been developed to identify postmenopausal women at risk of low bone mineral density who need to undergo BMD testing. The aim of study was to compare performance of three decision rules for identifying women with primary osteoporosis in an Iranian postmenopausal population. Materials and Methods: Three osteoporosis risk indices- the osteoporosis self assessment tool (OST), the osteoporosis risk assessment instrument (ORAl), and body weight criterion were calculated for 5573 out patients without risk factors for secondary osteoporosis or receiving active bone medication. BMD at spine and femoral neck were measured via dual x-ray absorptiomety. The sensitivity, specificity, positive predictive value, negative predicative value and area under receiver operating characteristic curve to identify those with osteoporosis were determined for each decision rule; these were then compared. Results: The sensitivity of these risk indices ranged from 70% to 84/l% and specificity from 44.6 to 65.6%. The area under curve (ROC) in identifying patients with osteoporosis were significantly better for OST (0.75) and ORAl (0.74) compared with the body weight criteria (0.66). The negative predicative values ranged from 80 to 93%, while positive predication values ranged from 33 to 45%. Conclusion: Our data provide evidence for the application of OST, ORAl as useful clinical tools in making decision about which women need to be referred for BMD testing; more evidence however is needed to confirm validity of the body weight criterion. Of the three tools evaluated, the OST is the simplest and has the best potential for use in clinical practice.