Evaluation of the validity of osteoporosis and fracture risk assessment tools (IOF One Minute Test, SCORE, and FRAX) in postmenopausal Palestinian women
Date
2016-12-24
Authors
Kharroubi, Akram
Saba, Elias
Ghannam, Ibrahim
Darwish, Hisham
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Nature policies
Abstract
The need for simple self-assessment tools is necessary
to predict women at high risk for developing osteoporosis.
In this study, tools like the IOF One Minute Test, Fracture
Risk Assessment Tool (FRAX), and Simple Calculated
Osteoporosis Risk Estimation (SCORE) were found to be valid
for Palestinian women. The threshold for predicting women
at risk for each tool was estimated.
Purpose The purpose of this study is to evaluate the validity
of the updated IOF (International Osteoporosis Foundation)
One Minute Osteoporosis Risk Assessment Test, FRAX,
SCORE as well as age alone to detect the risk of developing
osteoporosis in postmenopausal Palestinian women.
Methods Three hundred eighty-two women 45 years and
older were recruited including 131 women with osteoporosis
and 251 controls following bone mineral density (BMD) measurement,
287 completed questionnaires of the different risk
assessment tools. Receiver operating characteristic (ROC)
curves were evaluated for each tool using bone BMD as the
gold standard for osteoporosis.
Results The area under the ROC curve (AUC) was the highest
for FRAX calculated with BMD for predicting hip fractures
(0.897) followed by FRAX for major fractures (0.826) with
cut-off values ˃1.5 and ˃7.8%, respectively. The IOF One
Minute Test AUC (0.629) was the lowest compared to other
tested tools but with sufficient accuracy for predicting the risk
of developing osteoporosis with a cut-off value ˃4 total yes
questions out of 18. SCORE test and age alone were also as
good predictors of risk for developing osteoporosis.
According to the ROC curve for age, women ≥64 years had
a higher risk of developing osteoporosis. Higher percentage of
women with low BMD (T-score ≤−1.5) or osteoporosis (Tscore
≤−2.5) was found among women who were not exposed
to the sun, who had menopause before the age of 45 years, or
had lower body mass index (BMI) compared to controls.
Women who often fall had lower BMI and approximately
27% of the recruited postmenopausal Palestinian women had
accidents that caused fractures.
Conclusions Simple self-assessment tools like FRAX without
BMD, SCORE, and the IOF One Minute Tests were valid for
predicting Palestinian postmenopausal women at high risk of
developing osteoporosis.
Description
Keywords
Postmenopausal osteoporosis , IOF One Minute Test , FRAX , SCORE , ROC curve , BMD