Diagnostic Performances Of Two Diagnostic Criteria For The Evaluation Of Osteoporosis

Objective: The threshold method based on the fracture risk prediction tool and the criteria for the diagnosis of primary osteoporosis(2017 edition)as the evaluation criteria for the efficacy of anti-osteoporosis drugs are discussed,and the diagnostic efficacy of the two diagnostic criteria is analyzed,in order to further clarify the FRAX(The status of the Fracture Risk Assessment Tool(FRAX)"treatment criteria" in the diagnosis of osteoporosis.Methods:Obtain the information of patients with previous baseline bone mineral density through the bone mineral density information registry of the First Affiliated Hospital of Hainan Medical College.A total of 1,514 hospitalized patients who had undergone bone mineral density testing were retrospectively reviewed from 2016 to2019,and the inpatient discharge diagnosis information was obtained from the information department;the FRAX score was calculated based on the diagnostic information during the hospitalization of the patients,and the bone mineral density test was followed up for fragility History of fractures.All patients were retrospectively classified according to the 2017 version of my country’s primary osteoporosis diagnosis guideline and the FRAX tool threshold method,and the fragility fracture was used as the gold standard to compare the diagnostic performance of the two standards.Results:Taking the fragility fractures followed up as the gold standard,1052 female patients were followed up,and the incidence of fractures in the main part was 2.9%;462 men had the incidence of fracture in the main part was 1.3%.For female patients,the diagnostic sensitivity of the diagnostic guidelines was 61.3%,and the "FRAX threshold method standard" was 51.6%;there was a statistical difference between the two.The diagnostic specificity of the FRAX threshold method is 73.2%,which is higher than the diagnostic guideline standard.The diagnostic specificity of the latter is 65%,and there is a statistical difference between the two.The 2017 diagnostic guidelines for primary osteoporosis and the area under the receiver operating curve of the FRAX threshold method were 0.631 and 0.624,respectively,and there was no statistical difference between the two.Among men,the sensitivity of the diagnostic guideline standard is 66.7%,and the sensitivity of the FRAX age threshold method is50%,and there is no statistical difference between the two;the diagnostic specificity of the diagnostic guideline standard is 84.2%,which is higher than the FRAX age threshold method,The specificity of the latter is 54.6%,there is a statistical difference between the two.The 2017 diagnostic guidelines for primary osteoporosis and the area under the receiver operating curve of the FRAX threshold method were0.754 and 0.633,respectively,and there was no statistical difference between the two.Conclusion: This study found that in female patients,the guideline version is more sensitive;it can be used for general screening in the population;the FRAX risk threshold method is more specific and can be used to further determine whether the patient is receiving treatment;but the accuracy of the two diagnostic criteria is not difference.Among men,the guideline version is more specific and can be used to identify low fracture risk and avoid unnecessary treatment;however,there is no difference in the accuracy and sensitivity of the two diagnostic criteria.