PMID- 26471931
OWN - NLM
STAT- MEDLINE
DCOM- 20160711
LR  - 20181202
IS  - 1873-4111 (Electronic)
IS  - 0378-5122 (Linking)
VI  - 83
DP  - 2016 Jan
TI  - Osteoporosis screening in postmenopausal women aged 50-64 years: BMI alone 
      compared with current screening tools.
PG  - 59-64
LID - S0378-5122(15)30058-X [pii]
LID - 10.1016/j.maturitas.2015.09.009 [doi]
AB  - OBJECTIVES: Consensus on when to initiate DXA screening for early postmenopausal 
      women (< 65 years of age) is lacking. Low body mass index (BMI) has been proposed 
      as one of the major risk factors for osteoporosis. This study sought to compare 
      the predictive performance of BMI alone with 5 screening modalities (the U.S. 
      Preventive services task force [USPSTF] FRAX threshold of 9.3%, a risk factor 
      based approach [>/= 1 risk factors], the osteoporosis self-assessment tool [OST < 
      2], the osteoporosis risk assessment instrument [ORAI >/= 9], and the simple 
      calculated osteoporosis risk estimation [SCORE >/= 6]) in identifying early 
      postmenopausal women with osteoporosis. METHODS: Postmenopausal women aged 50-64 
      years presenting for a DXA test were recruited between January 1, 2007, and March 
      1, 2009. Demographic data and osteoporosis risk factors were obtained through a 
      telephone survey. The performance of each screening tool in predicting 
      osteoporosis was compared. RESULTS: Of 445 study participants, 95% were White, 38 
      had osteoporosis (T-score </= -2.5). BMI (< 28) was associated with the highest 
      Sensitivity (95%), the lowest Negative Likelihood Ratio (LR-) of 0.14, an AUC of 
      0.73, and the number needed to scan (NNS) of 8. The USPSTF approach had the 
      lowest sensitivity (24%), highest LR- (0.91), lowest AUC (0.62), and highest NNS 
      (9). Among 5 established modalities, SCORE (>/= 6) appears to be the best 
      (sensitivity: 92%, LR-: 0.24, AUC: 0.75, NNS: 9). CONCLUSION: BMI (< 28) had a 
      comparable numerical screening performance overall to the current screening 
      modalities. BMI (< 28) could be considered a potential indicator when screening 
      early postmenopausal White women for osteoporosis. However, a better osteoporosis 
      screening tool remains to be developed.
CI  - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
FAU - Jiang, Xuezhi
AU  - Jiang X
AD  - Reading Hospital, Department of Obstetrics and Gynecology, Reading, PA, United 
      States; Sidney Kimmel Medical College of Thomas Jefferson University, Department 
      of Obstetrics and Gynecology, Philadelphia, PA, United States. Electronic 
      address: Daniel.Jiang@readinghealth.org.
FAU - Good, Lauren E
AU  - Good LE
AD  - Reading Hospital, Department of Obstetrics and Gynecology, Reading, PA, United 
      States.
FAU - Spinka, Ryan
AU  - Spinka R
AD  - Reading Hospital, Department of Obstetrics and Gynecology, Reading, PA, United 
      States.
FAU - Schnatz, Peter F
AU  - Schnatz PF
AD  - Reading Hospital, Department of Obstetrics and Gynecology, Reading, PA, United 
      States; Reading Hospital, Department of Internal Medicine, Reading, PA, United 
      States; Sidney Kimmel Medical College of Thomas Jefferson University, Department 
      of Obstetrics and Gynecology, Philadelphia, PA, United States; Sidney Kimmel 
      Medical College of Thomas Jefferson University, Department of Internal Medicine, 
      Philadelphia, PA, United States.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20151003
PL  - Ireland
TA  - Maturitas
JT  - Maturitas
JID - 7807333
SB  - IM
MH  - *Absorptiometry, Photon
MH  - Area Under Curve
MH  - *Body Mass Index
MH  - Bone Density
MH  - Female
MH  - Humans
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Osteoporosis/*diagnosis
MH  - Postmenopause
MH  - Predictive Value of Tests
MH  - Risk Assessment
MH  - Risk Factors
OTO - NOTNLM
OT  - Bone mineral density
OT  - DXA scan
OT  - Early postmenopausal women
OT  - Osteoporosis screening
EDAT- 2015/10/17 06:00
MHDA- 2016/07/12 06:00
CRDT- 2015/10/17 06:00
PHST- 2015/07/20 00:00 [received]
PHST- 2015/09/25 00:00 [revised]
PHST- 2015/09/28 00:00 [accepted]
PHST- 2015/10/17 06:00 [entrez]
PHST- 2015/10/17 06:00 [pubmed]
PHST- 2016/07/12 06:00 [medline]
AID - S0378-5122(15)30058-X [pii]
AID - 10.1016/j.maturitas.2015.09.009 [doi]
PST - ppublish
SO  - Maturitas. 2016 Jan;83:59-64. doi: 10.1016/j.maturitas.2015.09.009. Epub 2015 Oct 
      3.