Value of Osteoporosis Self-assessment Tools for Asians (OSTA) with or without Brown's clinical risk factors in detection of postmenopausal osteoporosis

ABSTRACT

Objective To evaluate the value of Osteoporosis Self-assessment Tools for Asians (OSTA) score, Brown's clinical risk assessment and their combination as screening tools for postmenopausal osteoporosis.

Methods Two hundred postmenopausal women were enrolled between August 2010 and January 2011. The weight and age of all participants were collected for the OSTA score. Clinical risk factors were collected for Brown's criteria. Bone mineral density was measured using dual-energy X-ray absorptiometry.

Results The mean age (± standard deviation (range)) of the studied population was 60.1 ± 7.8 (41–81) years. Twenty-one percent of the participants had either osteoporosis of the lumbar spine, or femoral neck or both, of which 8% had osteoporosis at the lumbar spine and 17% had osteoporosis at the femoral neck. The sensitivity and specificity for OSTA score cut-off values of ≤ −1 were 78.6% and 58.2% and for Brown's clinical risk factors were 57.1% and 71.5%, respectively. When the OSTA score of ≤ −1 and Brown's clinical risk factors were combined to screen participants with positive values for one or both test(s), the sensitivity increased from 78.6% to 81.0%, while the specificity decreased from 58.2% to 50.6%. The positive predictive values of the OSTA score, Brown's clinical criteria and the combined tools ranged between 30.4 and 70.6%.

Conclusions An OSTA score of ≤ −1 seems to have higher sensitivity compared to Brown's clinical risk factor assessment. The combination of both tools provides a slight improvement in sensitivity but with a decline in specificity.

Key words::

• OSTA SCORE
• BROWN’S CLINICAL RISK FACTORS
• SCREENING TOOL
• MENOPAUSAL OSTEOPOROSIS

ACKNOWLEDGEMENTS

The authors would like to thank Professor Sompop Limpongsanurak, MD, former head of Department of Obstetrics-Gynecology and Associate Professor Dhiraphongs Charoenvidhya, MD, head of Department of Obstetrics- Gynecology, for permission to conduct this research. Further, we would like to express our thanks to Mrs Tanimporn Ninlagarn, MA and Ms Somtawin Pojjanasopanakun, BSc, a staff member of the Menopausal Research Unit, for their assistance.

Conflict of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding This research received a grant from the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University.