Validity of Self-Reported Diagnosis of Osteoporosis in Japan Nurses’ Health Study

Figures & data

Table 1 Numbers of Subjects in Each Age Group at Baseline

Age	n	%
< 30	692	4.4
30–34	2955	18.8
35–39	3176	20.2
40–44	3133	19.9
45–49	2767	17.6
50–54	2012	12.8
55–59	797	5.1
60–64	143	0.9
≥ 65	42	0.3

Figure 1 Flow diagram illustrating data collection and corroboration in Japan Nurses’ Health Study.

Table 2 Drugs with Grade A Effectiveness for Bone Mineral Density in the Guideline for the Prevention and Treatment of Osteoporosis

Bisphosphonate	Alendronate
	Risedronate
	Minodronate
	Ibandronate
	Etidronate
PTH	Teriparatide
Anti-RANKL antibody	Denosumab
SERM	Raloxifene
	Bazedoxifene
Active vitamin D3	Eldecalcitol
Estrogen	Conjugated estrogens 1)
	Estradiol

Note: 1) Excluded for women aged 20 to 44 years because conjugated estrogens are mainly used to treat ovarian insufficiency in these patients.

Abbreviations: SERM, selective estrogen receptor modulator; PTH, parathyroid hormone; RANKL, receptor activator of NF-κB ligand.

Figure 2 Flow diagram illustrating the validation process of osteoporosis and the results.

Notes: 1) Including 11 deaths, 69 withdrawals, and 4 cases of missing data. 2) Including 10 cases who gave a response other than “positive” or “negative.” 3) Diagnosis by baseline and regular follow-up questionnaires.

Abbreviations: OP, osteoporosis; DCO, diagnostic circumstances only.

Figure 3 Cumulative incidence of osteoporosis in Japan Nurses’ Health Study.

Table 3 Self-Report PPV/NPV for Osteoporosis (Validation Samples =15,717)

		Expert Review
		BL+Regular Follow-Up		BL+Regular Follow-Up + Confirmation Questionnaire
	Positive Diagnosis Self-Reported in BL +Regular Follow-Up	PPV	NPV	PPV	NPV
Osteoporosis	1189	61.3%	98.9%	85.6%	98.2%

Abbreviations: BL, baseline; PPV, positive predictive value; NPV, negative predictive value.