三种不同骨质疏松症风险评估工具的比较：ORAI（骨质疏松症风险评估仪器）、SCORE（简易计算骨质疏松症风险估计）和OST（骨质疏松症自我评估工具）。
Comparison of three different osteoporosis risk assessment tools: ORAI (osteoporosis risk assessment instrument), SCORE (simple calculated osteoporosis risk estimation) and OST (osteoporosis self-assessment tool).
作者信息
Ahmadzadeh Arman, Emam Mohammadmehdi, Rajaei Alireza, Moslemizadeh Mohammad, Jalessi Maryam
机构信息
1. Assistant Professor of Rheumatology, Rheumatology Department, Loghman Hakim hospital, Shaheed Beheshti University of Medical Sciences (SBUMC), Tehran, Iran.
2. Assistant Professor of Rheumatology, Rheumatology Department, Loghman Hakim hospital, Shaheed Beheshti University of Medical Sciences (SBUMC), Tehran, Iran.
出版信息
Med J Islam Repub Iran. 2014 Sep 15;28:94. eCollection 2014.
BACKGROUND
SCORE, OST and ORAI risk assessment tools could reduce the cost burden of BMD tests by selecting the high risk patients to osteoporosis. In this study we compared the ability of these risk assessment measures to assess probability of the osteoporosis among post-menopausal women.
METHODS
211 post-menopausal women aged 45-88 years enrolled into the study. All of the patients underwent BMD test and divided into two groups according to T-Score level. 43 patients (20.4%) had T-Score ≤-2.5 (osteoporotic) (group-1) and 168 (70.6%) patients had T-Score of > -2.5 (non-osteoporotic). Among 168 nonosteoporotic cases, 88 had -2.5≤T-Score≤-2 in at least one bony area. These 88 cases in addition to the 43 cases with -2.5≤T-Score considered as high risk group to osteoporosis (group 2). Afterward, SCORE, OST and ORAI risk scores were calculated and sensitivity, specificity, likelihood ratio, accuracy index and area under the curve of each tool were determined in both groups and then compared with each other.
RESULTS
SCORE had the highest sensitivity compared with others in both groups (95% and 88.2% respectively). Moreover, it had the highest diagnostic odds ratio and negative predictive value between the three methods. OST had the highest likelihood ratio and specificity in both groups (71.4% and 75.4%). There was significant difference between the sensitivity and specificity of the tests (p= 0.004 and 0.027).
CONCLUSION
OST with the highest specificity and positive LR had a special role in determining the osteoporotic patients and SCORE with the highest sensitivity and negative predictive value had an exceptional role in exclusion of the non- osteoporotic individuals. However, considering the area under the curve, there was no significant difference among these three methods in determining osteoporosis.
背景
SCORE、OST和ORAI风险评估工具可通过筛选出骨质疏松高危患者来减轻骨密度检测的成本负担。在本研究中，我们比较了这些风险评估措施评估绝经后女性骨质疏松概率的能力。
方法
211名年龄在45 - 88岁的绝经后女性纳入本研究。所有患者均接受骨密度检测，并根据T值水平分为两组。43例患者（20.4%）T值≤ -2.5（骨质疏松）（第1组），168例患者（70.6%）T值> -2.5（非骨质疏松）。在168例非骨质疏松病例中，88例在至少一个骨区域T值为-2.5≤T值≤ -2。这88例病例加上43例T值≤ -2.5的病例被视为骨质疏松高危组（第2组）。随后，计算SCORE、OST和ORAI风险评分，并确定两组中每种工具的敏感性、特异性、似然比、准确性指数和曲线下面积，然后相互比较。
结果
在两组中，SCORE的敏感性均高于其他工具（分别为95%和88.2%）。此外，在三种方法中它具有最高的诊断比值比和阴性预测值。OST在两组中具有最高的似然比和特异性（分别为71.4%和75.4%）。各检测方法的敏感性和特异性之间存在显著差异（p = 0.004和0.027）。
结论
特异性和阳性似然比最高的OST在确定骨质疏松患者方面具有特殊作用，敏感性和阴性预测值最高的SCORE在排除非骨质疏松个体方面具有特殊作用。然而，考虑到曲线下面积，这三种方法在确定骨质疏松方面没有显著差异。
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