Abstract
Self-assessment indices are questionnaires or nomograms that utilize risk factors for low bone mass or osteoporosis to identify women who are likely to have a low bone density. Most indices have focused on women although self-assessment indices have begun to appear for men. Women and men who are identified in this fashion should be considered candidates for a bone density measurement. Although a man or woman can have a low bone density in the absence of any identifiable risk factors, these indices are useful in a variety of ways. They can help select those individuals who are less likely to have a low bone density as well as those who are more likely. Because most of these indices can be self-administered by the patient, they foster patient education and awareness and encourage the patient to initiate the discussion of bone density testing and osteoporosis with the physician.
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Notes
- 1.
See Chapter 3 for a discussion of regression analysis, sensitivity, and specificity, ROC curves and likelihood ratios.
- 2.
See Chapter 3 for a discussion of linear regression.
- 3.
The example is calculated as follows: +5 for race, 0 for no history of rheumatoid arthritis, +4 for the history of wrist fracture after age 45, +(3 × 6) for age, +1 for history of no estrogen use, and – (1 × 12) for weight. The sum is 16.
- 4.
The Canadian Multicentre Osteoporosis Study (CaMos) is a population-based cohort study in which risk factors for osteoporosis, BMD, and osteoporotic fracture are being evaluated over a 5-year period.
- 5.
See Chapter 9 for a discussion of the World Health Organization criteria for the diagnosis of osteoporosis based on measurement of the bone density.
- 6.
See Chapter 6 for a discussion of the NHANES III proximal femur database.
- 7.
The OSTA score is calculated as follows: (56 – 64) × 0.2 = –1.6. This value is truncated to an integer resulting in an OSTA score of –1.
- 8.
Note that the original OSTA index cutpoint value for women was –1 or below, not 0 or below.
- 9.
The Study of Osteoporotic Fractures (SOF) is a prospective study of 9704 women at least 65 years of age. Caucasian women make up 99.7% of the study population.
- 10.
The score of 4 is used as a dichotomous cutpoint. The sensitivity and specificity given here are for all scores of 4 or higher considered as a group, while a second group would be all scores of 3 or lower. The specificity and sensitivity for an exact score of 4, 5 or 6, etc. would be different.
- 11.
EPIDOS is a prospective study of risk factors for hip fracture in France. 7575 women aged 75 and older were recruited for the study during 1992 and 1993 and followed every 4 months for the duration of the study. The data presented here is based on a mean follow-up of 4 years.
- 12.
See Chapter 7 for a discussion of the 1998 NOF guidelines.
- 13.
The mean and SD at the femoral neck in the NHANES III non-Hispanic white female database are 0.858Â g/cm2 and 0.120Â g/cm2, respectively.
- 14.
NOF guidelines 2; SCORE 6; ORAI 9; ABONE 2; Weight < 154Â lb (70Â kg)
- 15.
See Chapter 3 for a discussion of sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC).
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Bonnick, S.L. (2010). Selecting Patients for Bone Mass Measurements: Self-Assessment Indices. In: Bone Densitometry in Clinical Practice. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-499-9_8
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