使用USPSTF推的骨质疏松风险评估工具识别患有骨质疏松的更年轻的绝经后妇女
Henry W Zheng1, Alex A T Bui2, Kristine E Ensrud3
1Medical and Imaging Informatics, UCLA (University of California, Los Angeles), Los Angeles.
JAMA network open
|March 18, 2025
概括
三种常见的骨质疏松风险评估工具显示,在年轻的绝经后妇女中,在识别低骨矿物质密度 (BMD) 时,其准确度相当或中等. 这凸显了当前对这一群体的查方法存在的差距.
科学领域:
- 骨健康和骨质疏松症研究
- 临床流行病学 临床流行病学
- 老年医学 老年医学
背景情况:
- 临床指南建议使用骨质疏松风险预测工具来识别更年轻的绝经后妇女的低骨矿物质密度 (BMD).
- 这些工具在这个特定的人口群体中的表现没有得到充分量化,需要进一步评估.
研究的目的:
- 将骨质疏松风险评估工具 (ORAI) 和骨质疏松风险指数 (OSIRIS) 与骨质疏松自我评估工具 (OST) 的性能进行比较.
- 评估这些工具在50-64岁妇女中识别骨质疏松性骨质疏松症的有效性.
主要方法:
- 一项采用女性健康倡议骨密度子研究数据的横截面研究.
- 包括50-64岁的健康的绝经后妇女, BMD测量.
- 在公布和替代分数截止点使用接收器运行特征曲线 (AUC) 下面的面积来评估OSIRIS,ORAI和OST.
主要成果:
- 该研究包括6067名参与者;14.1%的人在三个评估的骨部位中的任何一个都有骨质疏松症.
- 鉴定骨质疏松症的AUC为OSIRIS的0.633,ORAI的0.663和OST的0.654. 这两种方法的AUC均为0.633和0.654.
- 这三种工具都在基于BMD T-score识别骨质疏松症时显示出公平到中度的歧视.
结论:
- 指南推的骨质疏松症风险评估工具在年轻的绝经后妇女中识别骨质疏松症方面表现相当到中等.
- 在常见的临床风险因素能够准确地识别这种人群中的骨质疏松症的能力方面存在很大的差距.
- 加强查策略对于减轻骨质疏松症和骨折的个人和社会负担至关重要.
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