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Performance of the Osteoporosis Self-assessment Screening Tool for Osteoporosis in American Men

  • Author Footnotes
    2 Dr Adler has received research grants from Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble and is a speaker or consultant for Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble.
    Robert A. Adler
    Correspondence
    Address reprint requests and correspondence to Robert A. Adler, MD, Endocrinology (111-P), McGuire Veterans Affairs Medical Center, 1201 Broad Rock Blvd, Richmond, VA 23249
    Footnotes
    2 Dr Adler has received research grants from Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble and is a speaker or consultant for Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble.
    Affiliations
    Endocrinology Section, McGuire Veterans Affairs Medical Center, Richmond

    Department of Internal Medicine, Medical College of Virginia/Virginia Commonwealth University, Richmond
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  • Author Footnotes
    1 Dr Tran is now with the Kaiser Permanente Colorado Region, Denver.
    Mongthuong T. Tran
    Footnotes
    1 Dr Tran is now with the Kaiser Permanente Colorado Region, Denver.
    Affiliations
    Endocrinology Section, McGuire Veterans Affairs Medical Center, Richmond
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  • Valentina I. Petkov
    Affiliations
    Endocrinology Section, McGuire Veterans Affairs Medical Center, Richmond
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  • Author Footnotes
    1 Dr Tran is now with the Kaiser Permanente Colorado Region, Denver.
    2 Dr Adler has received research grants from Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble and is a speaker or consultant for Merck & Co, Inc, Eli Lilly and Company, Novartis, and Procter & Gamble.

      Objective

      To determine whether the Osteoporosis Self-assessment Tool (OST) can predict central bone mineral density in men, as defined by dual energy x-ray absorptiometry (DXA).

      Patients and Methods

      We applied the OST index to men in pulmonary (evaluated January-May 2001) and rheumatology (evaluated November 2001-March 2002) clinics at a veterans hospital. The calculated OST risk index is based on weight and age.

      Results

      In 181 men, we arbitrarily defined osteoporosis as a DXA T score of −2.5 or less in the spine, total hip, or femoral neck. The mean age and weight of the men were 64.3 years and 91.2 kg; 15.6% had osteoporosis by DXA. The OST index ranged from −5 to 19, from which we categorized risk as follows: low, 4 or greater; moderate, −1 to 3; and high, −2 or less. Only 2.0% of men with a low-risk OST index had osteoporosis, whereas 27.0% with a moderate risk and 72.7% with a high risk had osteoporosis. Using an OST cutoff score of 3, we predicted osteoporosis with a sensitivity of 93% and a specificity of 66%. When patients were studied by age in decades, race, or current glucocorticoid use, the predictive value of the OST was maintained.

      Conclusion

      The OST is an easy method to predict osteoporosis by DXA.
      AUC (area under the curve), BMD (bone mineral density), DXA (dual energy x-ray absorptiometry), OST (Osteoporosis Self-assessment Tool)
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