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Identifying Younger Postmenopausal Women With Osteoporosis Using USPSTF-Recommended Osteoporosis Risk Assessment

Henry W Zheng1, Alex A T Bui2, Kristine E Ensrud3

  • 1Medical and Imaging Informatics, UCLA (University of California, Los Angeles), Los Angeles.

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Summary
This summary is machine-generated.

Three common osteoporosis risk assessment tools showed fair to moderate accuracy in identifying low bone mineral density (BMD) in younger postmenopausal women. This highlights a gap in current screening methods for this demographic.

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Area of Science:

  • Bone Health and Osteoporosis Research
  • Clinical Epidemiology
  • Geriatric Medicine

Background:

  • Clinical guidelines recommend osteoporosis risk prediction tools for identifying low bone mineral density (BMD) in younger postmenopausal women.
  • The performance of these tools in this specific demographic is not well-quantified, necessitating further evaluation.

Purpose of the Study:

  • To compare the performance of the Osteoporosis Risk Assessment Instrument (ORAI) and Osteoporosis Index of Risk (OSIRIS) against the Osteoporosis Self-Assessment Tool (OST).
  • To evaluate the efficacy of these tools in identifying osteoporotic BMD among women aged 50-64 years.

Main Methods:

  • A cross-sectional study utilizing data from the Women's Health Initiative Bone Density Substudy.
  • Included healthy postmenopausal women aged 50-64 years with BMD measurements.
  • Evaluated OSIRIS, ORAI, and OST using area under the receiver operating characteristic curve (AUC) at published and alternate score cutoffs.

Main Results:

  • The study included 6067 participants; 14.1% had osteoporosis at any of the three assessed skeletal sites.
  • The AUC for identifying osteoporosis was 0.633 for OSIRIS, 0.663 for ORAI, and 0.654 for OST.
  • All three tools demonstrated fair to moderate discrimination in identifying osteoporosis based on BMD T-scores.

Conclusions:

  • Guideline-recommended osteoporosis risk assessment tools exhibit fair to moderate performance in identifying osteoporosis in younger postmenopausal women.
  • A significant gap exists in the ability of common clinical risk factors to accurately identify osteoporosis in this population.
  • Enhanced screening strategies are crucial to mitigate the individual and societal burden of osteoporosis and fractures.