The Evaluation And Establishment Of Osteoporosis Screening Tool For Women Of 50 Years Old And Above

Objectives To evaluate the screening effect of OSTA in Chinese women of 50 years old and above. According to the diagnostic criteria approved by WHO, bone mineral content (BMC) was used to establish osteoporosis (OP) screening tool for Sichuan women of 50 years old and above, and to provide suggestions and methodology reference for the further development of OP screening and diagnosis.Methods According to the equation of OSTA and original cutpoints, each subject was calculated a score and classified into three risk levels(the nomal, the osteopenia and the osteoporosis) or two(the low and the high risk). A series of screening indexes, such as sensitivity, specificity and kappa value were employed to compare and analyze the diagnosis results of OSTA with T-score from the femoral neck bone density. The main influencing factors of BMC were selected by the multiple linear regression. Fisher discriminant analysis was adopted to establish the OP screening tool for Sichuan women. ROC curve were used to evaluate screening results.Results According to the original cutpoints developed by L.K.H.Koh and other researchers, the consistency of the diagnosis result between T-score and OSTA about Chinese women of 50 years old and above was not satisfied, and the clinical applicability of OSTA was finite. As to the two group, the diagnosis results was not satisfied either. After adjusting the cutpoints, the sensitivity and negative predictive value had increased, but the consistency had not been improved. About the data of Sichuan province in "Ninth Five" Science and Technology Key Task, weight, age, stature, menopause time and brittle fracture were the main influencing factors using the stepwise regression. The OP screening tool for women in Sichuan was set up through the Fisher discriminant analysis. Taking account of the practicality and simplicity of screening tool, only weight and age were included in the model. The area under the ROC curve of new tool was 0.828 (P<0.05). The cutpoint 86 was determinded, when the sensitivity was 90.5% and specificity was 50.0%.Conclusions The original cutpoints of OSTA did not adapt to Chinese women of 50 years old and above for osteoporosis risk screening. After adjusting the cutpoints, its effect was still not ideal. The stepwise regression results showed that the main factors influencing the BMC were weight and age. The new screening tool had high accuracy for screening. We suggested this screening tool could be used to screen OP for women in Sichuan. Meanwhile, it was showed that the BMC had a certain diagnostic value, but there being no gold standard, the diagnostic value of BMC still need further research.