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Titolo:
Evaluation of the simple calculated osteoporosis risk estimation (SCORE) in a sample of white women from Belgium
Autore:
Ben Sedrine, W; Devogelaer, JP; Kaufman, JM; Goemaere, S; Depresseux, G; Zegels, B; Deroisy, R; Reginster, JY;
Indirizzi:
Univ Liege, Dept Epidemiol & Publ Hlth, Liege, Belgium Univ Liege Liege Belgium ge, Dept Epidemiol & Publ Hlth, Liege, Belgium WHO Collaborating Ctr Publ Hlth Aspects Osteoarti, Liege, Belgium WHO Collaborating Ctr Publ Hlth Aspects Osteoarti Liege Belgium Belgium St Luc Univ Hosp, Dept Rheumatol, Brussels, Belgium St Luc Univ Hosp Brussels Belgium sp, Dept Rheumatol, Brussels, Belgium Univ Hosp Gent, Dept Endocrinol, Ghent, Belgium Univ Hosp Gent Ghent Belgium Hosp Gent, Dept Endocrinol, Ghent, Belgium Univ Liege, Bone & Cartilage Metab Unit, Liege, Belgium Univ Liege LiegeBelgium e, Bone & Cartilage Metab Unit, Liege, Belgium Georgetown Univ, Med Ctr, Washington, DC 20007 USA Georgetown Univ Washington DC USA 20007 Med Ctr, Washington, DC 20007 USA
Titolo Testata:
BONE
fascicolo: 4, volume: 29, anno: 2001,
pagine: 374 - 380
SICI:
8756-3282(200110)29:4<374:EOTSCO>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE DENSITOMETRY; HIP-FRACTURES; VALIDATION; DENSITY; SELECTION;
Keywords:
osteoporosis; postmenopausal; screening; simple calculated osteoporosis risk estimation (SCORE); densitometry; cost-saving;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Reginster, JY CHU Ctr Ville, Bone & Cartilage Metab Unit, Quai G Kurth 45,B-4020 Liege,Belgium CHU Ctr Ville Quai G Kurth 45 Liege Belgium B-4020 ,Belgium
Citazione:
W. Ben Sedrine et al., "Evaluation of the simple calculated osteoporosis risk estimation (SCORE) in a sample of white women from Belgium", BONE, 29(4), 2001, pp. 374-380

Abstract

Identifying patients at risk of developing an osteoporosis-related fracture will continue to be a challenge. The "gold standard" for osteoporosis diagnosis is bone densitometry. However, economic issues or availability of the technology may prevent its use under a mass screening scenario. A risk assessment instrument, the "simple calculated osteoporosis risk estimation" (SCORE), has been reported to appropriately identify women likely to have low (t score less than or equal to -2 SD) bone mineral density (BMD) and who should be referred for bone densitometry. The aim of our study is to evaluate the discriminatory performance of SCORE in a random sample of postmenopausal white women from Belgium. For this purpose, we gathered medical data on 4035 consecutive patients aged greater than or equal to 45 years, either consulting spontaneously or referred for a BMD measurement to an outpatientosteoporosis center located at the University of Liege Belgium. BMD measurements, using dual-energy X-ray absorptiometry (DXA) technology, were takenat the hip (total and neck) and lumbar spine (L2-4). At the recommended cutoff point of 6, SCORE had a sensitivity of 91.5% to detect low BMD at any of the measured sites, a specificity of 26.5%, a positive predictive value of 52.8%, and a negative predictive value or 77.7%. According to SCORE, 18%of the patients would not be recommended for densitometry. Among these, 10.9% were misclassified as they had osteoporosis (t score less than or equalto -2.5 SD) at one or more of the sites investigated. The negative predictive errors of SCORE, when failing to detect osteoporosis, were only 1% for the total hip, 3.2% for the femoral neck, and 8.8% for the lumbar spine. Weconclude that, notwithstanding the high values of sensitivity, SCORE specificity is too low to be useful as a diagnostic tool for screening patients at high risk to later develop osteoporosis. Nevertheless, from a resource allocation perspective, this instrument can be used with relative confidenceto exclude patients who do not need a BMD measurement, and would thereforeprovide an opportunity to realize substantial cost savings in comparison to a mass screening strategy. (Bone 29:374-380;2001) (C) 2001 by Elsevier Science Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/06/20 alle ore 03:13:00