title: Validation of the Male Osteoporosis Risk Estimation Score (MORES) in a primary care setting.
abstract: BACKGROUND
  Primary care physicians are positioned to promote early recognition and treatment of men at risk for osteoporosis-related fractures; however, efficient screening strategies are needed. This study was designed to validate the Male Osteoporosis Risk Estimation Score (MORES) for identifying men at increased risk of osteoporosis.
  
  
  METHODS
  This was a blinded analysis of the MORES, administered prospectively in a cross-sectional sample of men aged 60 years or older. Participants completed a research questionnaire at an outpatient visit and had a dual-energy X-ray absorptiometry (DXA) scan to assess bone density. Sensitivity, specificity, and area under-the-curve (AUC) were estimated for the MORES. Effectiveness was assessed by the number needed-to-screen (NNS) to prevent one additional major osteoporotic fracture.
  
  
  RESULTS
  A total of 346 men completed the study. The mean age was 70.2 ± 6.9 years; 76% were non-Hispanic white. Fifteen men (4.3%) had osteoporosis of the hip. The operating characteristics were sensitivity 0.80 (95% confidence interval [CI], 0.52-0.96); specificity 0.70 (95% CI, 0.64-0.74), and AUC of 0.82 (95% CI, 0.71-0.92). Screening with the MORES yielded a NNS to prevent one additional major osteoporotic fracture over 10 years with 259 (95% CI, 192-449) compared to 636 for universal screening with a DXA.
  
  
  CONCLUSIONS
  This study validated the MORES as an effective and efficient approach to identifying men at increased risk of osteoporosis who may benefit from a diagnostic DXA scan.
authors.affiliation: Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX 77555-1123, USA. acass@utmb.edu
authors.forename: Alvah R
authors.initials: AR
authors.lastname: Cass
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Shepherd
mesh_terms: D000368:Aged; D000465:Algorithms; D003430:Cross-Sectional Studies; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D011320:Primary Health Care; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
keywords: Decision Making; Men's Health; Osteoporosis; Prevention; Primary Health Care; Screening