title: The Canadian SCORE questionnaire: optimizing the use of technology for low bone density assessment. Simple Calculated Osteoporosis Risk Estimate.
abstract: The Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire is a tool to assist physicians to identify women who might require bone densitometry. The purpose of this study was to develop a Canadian SCORE and to assess validity and reliability. Twenty sites enrolled 307 postmenopausal women ages 50-70 yr. SCORE results were compared to hip and lumbar spine bone density assessed by dual X-ray absorptiometry. Sensitivity and specificity of a range of SCORE cut-points were assessed in a receiver operating characteristics analysis to determine the optimal cut-point for SCORE. With low bone density defined as a T-score < or = -2.0, a SCORE cut-point of 6 in women ages 50-59 yr displayed a sensitivity of 0. 96, 95% confidence interval (CI) (0.89, 1.00), a specificity of 0.51, 95% CI (0.43, 0.58). In women ages 60-70 yr, a SCORE cut-point of 8 displayed a sensitivity of 0.90, 95% CI (0.80, 0.97) and a specificity of 0.20, 95% CI (0.11, 0.29). The test-retest reliability (intraclass correlation coefficient) was 0.95. SCORE performed better in women in their fifties than women in ther sixties. Older women require higher SCORE cut-points. The use of SCORE as an initial measure for identifying those at risk for osteoporosis may reduce costs by limiting unnecessary tests.
authors.affiliation: Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. wendy.ungar@sickkids.on.ca
authors.forename: W J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: R
authors.initials: R
authors.lastname: Josse
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: N
authors.initials: N
authors.lastname: Ryan
authors.forename: R
authors.initials: R
authors.lastname: Adachi
authors.forename: D
authors.initials: D
authors.lastname: Hanley
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: M C
authors.initials: MC
authors.lastname: Breton
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D002170:Canada; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires