title: Developing a Malaysian Osteoporosis Screening Tool (MOST) for early osteoporosis detection in Malaysian women.
abstract: BACKGROUND
  Osteoporotic fracture is a major health burden. Early diagnosis and management would improve the quality of life and reduce costs to the society.
  
  
  OBJECTIVE
  We aimed to identify risk factors associated with osteoporosis followed by development and validation of a screening tool in the hope of providing an appropriate regime to detect low bone density (BMD) in Malaysia.
  
  
  METHODS
  Between November 1999 and November 2002, 514 healthy women aged ≥ 45 with intact uterus, non-HRT users were recruited. Following BMD testing, a screening tool was developed. For validation, 72 women were recruited from June 2003 to December 2003.
  
  
  RESULTS
  Age and a longer duration postmenopause were negatively linked to BMD. Higher family income, BMI, waist and hip circumference were positively correlated. A score of ≥ 4, the screening tool had a sensitivity of 73.2%, a specificity of 61.6% for identifying women with low BMD (T score ≤ -2) plus a sensitivity of 80.2% in selecting women with osteoporosis. The tool enabled a 45.9% reduction in unnecessary DEXA testing. Validation of the screening tool showed a negative predictive value of 97.8%, sensitivity and specificity of 87.5% and 70.3%, respectively.
  
  
  CONCLUSIONS
  The Malaysian Osteoporosis Screening Tool (MOST) is relatively simple. Its usage may reduce unnecessary DEXA test.
authors: Department of O&G, Medical Faculty, Universiti Kebangsaan Malaysia, Malaysia. peishan9900@yahoo.com
authors: Lim Pei
authors: LP
authors: Shan
authors: Ong Fee
authors: OF
authors: Bee
authors: Sufian Seri
authors: SS
authors: Suniza
authors: Nafisah
authors: N
authors: Adeeb
mesh_terms: D015502:Absorptiometry, Photon; D000367:Age Factors; D015992:Body Mass Index; D001837:Body Weights and Measures; D015519:Bone Density; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007182:Income; D008296:Malaysia; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055105:Waist Circumference; D049629:Waist-Hip Ratio