Validation of an osteoporosis self-assessment tool to identify primary osteoporosis and new osteoporotic vertebral fractures in postmenopausal Chinese women in Beijing.
BACKGROUND
This study aimed to validate the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in identifying postmenopausal women at increased risk of primary osteoporosis and painful new osteoporotic vertebral fractures in a large selected Han Chinese population in Beijing.


METHODS
We assessed the performance of the OSTA in 1201 women. Subjects with an OSTA index > -1 were classified as the low risk group, and those with an index ≤ -1 were classified as the increased risk group. Osteoporosis is defined by a T-score ≤ 2.5 standard deviations according to the WHO criteria. All painful, new vertebral fractures were identified by X-ray and MRI scans with correlating clinical signs and symptoms. We determined the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve for correctly selecting women with osteoporosis and painful new vertebral fractures.


RESULTS
Of the study subjects, 29.3% had osteoporosis, and the prevalence of osteoporosis increased progressively with age. The areas under the ROC curves of the OSTA index (cutoff = -1) to identify osteoporosis in the femoral neck, total hip, and lumbar spine were 0.824, 0.824, and 0.776, respectively. The sensitivity and specificity of the OSTA index (cutoff = -1) to identify osteoporosis in healthy women were 66% and 76%, respectively. With regard to painful new vertebral fractures, the area under the ROC curve relating the OSTA index (cutoff = -1) to new vertebral fractures was 0.812.


CONCLUSIONS
The OSTA may be a simple and effective tool for identifying the risk of osteoporosis and new painful osteoporotic vertebral fractures in Han Chinese women.
Clinical Osteoporosis Center, Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. feiqi@medmail.com.cn.
Yong
Y
Yang
Bingqiang
B
Wang
Qi
Q
Fei
Qian
Q
Meng
Dong
D
Li
Hai
H
Tang
Jinjun
J
Li
Nan
N
Su
D015502:Absorptiometry, Photon; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D044466:Asian People / Q000523:psychology*; D002681:China; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D010147:Pain Measurement; D017698:Postmenopause; D011237:Predictive Value of Tests; D015995:Prevalence; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012647:Self-Assessment; D012737:Sex Factors; D016103:Spinal Fractures / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D011795:Surveys and Questionnaires