Diagnostic Value of Quantitative Ultrasound for Osteoporosis in Elderly Women: A Meta-Analysis

To assess the reliability of quantitative ultrasound (QUS) in diagnosing and screening osteoporosis in elder women.

We conducted a systematic search of the online databases, including PubMed, Embase, Web of Science, and China National Knowledge, and screened the studies according to the inclusion criteria. We directly extract or calculate the value of true positive (TP), false positive (FP), false negative (FN), and true negative (TN) from eligible studies. We sought to evaluate the diagnostic parameters of QUS, containing the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC).

Twelve studies were included in this study with a total of 2260 women. QUS showed a pooled diagnostic odds ratio of 5.07 (95% CI 3.28-7.84), sensitivity of 0.69 (95% CI 0.65-0.72), specificity of 0.67 (95% CI 0.64-0.69), and an AUC of 0.7523 (Q*=0.6953). There was no obvious heterogeneity and threshold effect according to the Spearman correlation coefficient (P = 0.059). No significant publication bias was found through the Deek's funnel.

Our study suggested that the diagnostic value of QUS for osteoporosis in elder women was acceptable, but the accuracy still needed to be improved, QUS can be recommended as a pre-screening tool for osteoporosis to determine whether DXA measurement was needed.