通过双能X射线吸收计对女性进行骨密度计的决定规则的评估
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
概括
简单计算的骨质疏松风险估计 (SCORE) 和骨质疏松风险评估仪器 (ORAI) 的决策规则比国家骨质疏松基金会 (NOF) 的指南更有效,用于识别需要骨矿物密度 (BMD) 测试的女性.
科学领域:
- 骨质疏松症的研究研究.
- 医学诊断 医学诊断 医学诊断
- 公共卫生查检查
背景情况:
- 识别骨矿物质密度 (BMD) 低的女性对于预防骨质疏松性骨折至关重要.
- 由于资源有限,不建议对低BMD进行普遍查.
研究的目的:
- 为了评估四个决策规则的诊断准确性:简单计算的骨质疏松风险估计 (SCORE),骨质疏松风险评估仪器 (ORAI),年龄,体型,没有雌激素 (ABONE) 和体重标准 (<70公斤).
- 为了将这些规则与国家骨质疏松症基金会 (NOF) 选择女性进行双能X射线吸收计 (DXA) 测试的实践指南进行比较.
主要方法:
- 来自加拿大多中心骨质疏松症研究 (CaMOS) 的数据分析,涉及2365名45岁以上的绝经后妇女.
- 对每个规则和NOF指南的接收器操作特征 (AUROC) 曲线下的灵敏度,特异性和区域的评估,用于识别低BMD的女性 (T-score < -1.0, < -2.0, ≤ -2.5).
主要成果:
- SCORE和ORAI展示了最高的AUROC曲线来识别低BMD的女性.
- 虽然NOF指南对于检测低BMD具有很高的灵敏度,但它们也导致了高比例的不必要的DXA测试.
- 发现ABONE和重量标准规则对案件调查无效.
结论:
- 在准 BMD 测试的高风险个体方面,SCORE 和 ORAI 决策规则优于 NOF 准则.
- 需要进一步的研究来评估SCORE和ORAI对密度计服务利用的临床实践可接受性和影响.
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