双エネルギーX線吸収測定法による骨密度測定のために女性を推薦するための決定規則の評価
S M Cadarette1, S B Jaglal, T M Murray
1Osteoporosis Research Program, Women's College Ambulatory Care Centre, Sunnybrook and Women's College Health Sciences Centre, 76 Grenville St, 10th Floor E, Room 1005, Toronto, Ontario, Canada M5S 1B2. s.cadarette@utoronto.ca
JAMA
|July 4, 2001
まとめ
単純計算骨粗鬆症リスク推定 (SCORE) と骨粗鬆症リスク評価ツール (ORAI) の決定規則は,骨粗鬆症財団 (NOF) のガイドラインよりも,骨のミネラル密度 (BMD) 検査を必要とする女性を特定するためにより効果的です.
科学分野:
- 骨粗鬆症の研究について
- 医療診断 医療診断
- 公衆衛生スクリーニング
背景:
- 低骨密度 (BMD) の女性を特定することは,骨粗鬆症の骨折を予防するために非常に重要です.
- 低BMDの普遍的なスクリーニングは,リソースの制限のために推奨されません.
研究 の 目的:
- 4つの決定ルールの診断の正確性を評価するために:単純計算された骨粗鬆症リスク推定 (SCORE),骨粗鬆症リスク評価器具 (ORAI),年齢,体型,エストロゲンなし (ABONE),および体重基準 (<70kg).
- これらのルールを,国家骨粗鬆症財団 (NOF) の女性を二重エネルギーX線吸収計 (DXA) 検査に選択するための実践ガイドラインと比較します.
主な方法:
- カナダ多センター骨粗鬆症研究 (CaMOS) のデータを分析し,45歳以上の2365人の閉経後の女性を対象とした.
- 各ルールとNOFガイドラインの受信機動作特性 (AUROC) 曲線の下の感度,特異性,面積の評価は,低BMD (T-スコア < -1.0, < -2.0,および ≤ -2.5) を有する女性を特定する NOFガイドラインです.
主要な成果:
- SCOREとORAIは,低BMDを有する女性を特定するための最高AUROC曲線を示しました.
- NOFのガイドラインは,低BMDを検出する際の感度が高いが,不必要なDXA検査の割合も高い.
- ABONEと重量基準の規則は,事件の調査に効果がないことが判明しました.
結論:
- SCOREとORAIの決定規則は,BMD検査のために高リスクの個人をターゲットにすることで,NOFのガイドラインに優れています.
- SCOREとORAIが密度測定サービスの利用に及ぼす臨床実務の許容性と影響を評価するために,さらなる研究が必要である.
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