A risk assessment tool (OsteoRisk) for identifying Latin American women with osteoporosis.
OBJECTIVE
To develop a simple and easy-to-use tool for identifying osteoporotic women (femoral neck bone mineral density [BMD] T-scores<or=-2.5) in Latin America.


METHODS
Retrospective study involving review of medical records.


METHODS
Osteoporosis clinics in 6 Latin American countries.


METHODS
Postmenopausal women ages >or=50 in Latin America who had femoral neck BMD measurements.


RESULTS
A risk index was developed from 1,547 patients based on least square regression using age, weight, history of fractures, and other variables as predictors for BMD T-score. The final model was simplified by reducing the number of predictors; sensitivity and specificity were evaluated before and after reducing the number of predictors to assess performance of the index. The final model included age, weight, country, estrogen use, and history of fractures as significant predictors for T-score. The resulting scoring index achieved 91% sensitivity and 47% specificity. Simplifying the index by using only age and weight yielded similar performance (sensitivity, 92%; specificity, 45%). Three risk categories were identified based on OsteoRisk, the index using only age and body weight: high-risk patients (index <=-2; 65.6% were osteoporotic), moderate-risk patients (-2< index <=1; 26.7% were osteoporotic), and low-risk patients (index>1; 8% were osteoporotic). Similar results were seen in a validation sample of 279 women in Brazil.


CONCLUSIONS
Age and weight alone performed well for predicting the risk of osteoporosis among postmenopausal women. The OsteoRisk is an easy-to-use tool that effectively targets the vast majority of osteoporotic patients in Latin America for evaluation with BMD.
Sen
Shuvayu S
SS
Merck & Company, Inc., Whitehouse Station, NJ 08999, USA. shuvayu_sen@merck.com <shuvayu_sen@merck.com>
Rives
Vincent P
VP
Messina
Osvaldo D
OD
Morales-Torres
Jorge
J
Riera
Gregorio
G
Angulo-Solimano
Juan M
JM
Neto
João F M
JF
Frisoli
Alberto
A
Sáenz
Ricardo C
RC
Geling
Olga
O
Ross
Philip D
PD
D000368:Aged; D019540:Area Under Curve; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D007843:Latin America; D016018:Least-Squares Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000175:diagnosis* / Q000503:physiopathology; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D044465:White People