title: BFH-OST, a new predictive screening tool for identifying osteoporosis in postmenopausal Han Chinese women.
abstract: OBJECTIVE
  To develop a simple new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in postmenopausal women and to compare its validity with the Osteoporosis Self-Assessment Tool for Asians (OSTA) in a Han Chinese population.
  
  
  METHODS
  A cross-sectional study was conducted, enrolling 1,721 community-dwelling postmenopausal Han Chinese women. All the subjects completed a structured questionnaire and had their bone mineral density measured using DXA. Using logistic regression analysis, we assessed the ability of numerous potential risk factors examined in the questionnaire to identify women with osteoporosis. Based on this analysis, we build a new predictive model, the Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OST). Receiver operating characteristic curves were generated to compare the validity of the new model and OSTA in identifying postmenopausal women at increased risk of primary osteoporosis as defined according to the World Health Organization criteria.
  
  
  RESULTS
  At screening, it was found that of the 1,721 subjects with DXA, 22.66% had osteoporosis and a further 47.36% had osteopenia. Of the items screened in the questionnaire, it was found that age, weight, height, body mass index, personal history of fracture after the age of 45 years, history of fragility fracture in either parent, current smoking, and consumption of three of more alcoholic drinks per day were all predictive of osteoporosis. However, age at menarche and menopause, years since menopause, and number of pregnancies and live births were irrelevant in this study. The logistic regression analysis and item reduction yielded a final tool (BFH-OST) based on age, body weight, height, and history of fracture after the age of 45 years. The BFH-OST index (cutoff =9.1), which performed better than OSTA, had a sensitivity of 73.6% and a specificity of 72.7% for identifying osteoporosis, with an area under the receiver operating characteristic curve of 0.797.
  
  
  CONCLUSIONS
  BFH-OST may be a powerful and cost-effective new clinical risk assessment tool for prescreening postmenopausal women at increased risk for osteoporosis by DXA, especially for Han Chinese women.
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: JiSheng
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: XiaoDong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Meng
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: BingQiang
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Fei
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis*; D012372:ROC Curve; D012307:Risk Factors; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: osteoporosis; osteoporosis screening tool; validation; women