Osteoporosis Screening in Postmenopausal Women 50-64 Years-Old: Comparison of U.S. Preventive Services Task Force Strategy and Two Traditional Strategies in the Women's Health Initiative.

Publication Type:

Journal Article

Source:

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (2014)

Keywords:

2014, February 2014, Public Health Sciences Division

Abstract:

The U.S. Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women younger than 65 years whose 10-year predicted risk of major osteoporotic fracture is ≥ 9.3%. For identifying screening candidates among women aged 50-64 years, it is uncertain how the USPSTF strategy compares with the Osteoporosis Self-Assessment Tool (OST) and the Simple Calculated Osteoporosis Risk Estimate (SCORE). We examined data (1994-2012) from 5165 Women's Health Initiative participants aged 50-64. For the USPSTF (FRAX major fracture risk ≥ 9.3% calculated without BMD), OST (score <2), and SCORE (score >7) strategies, we assessed sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) to discriminate between those with and without femoral neck (FN) T-score ≤ -2.5. Sensitivity, specificity, and AUC for identifying FN T-score ≤ -2.5 were 34.1%, 85.8%, and 0.60 for USPSTF (FRAX), 74.0%, 70.8%, and 0.72 for SCORE, and 79.8%, 66.3%, and 0.73 for OST. The USPSTF strategy identified about 1/3(rd) of women aged 50-64 with FN T-scores ≤ -2.5. Among women aged 50-64 years, the USPSTF strategy was modestly better than chance alone and inferior to conventional SCORE and OST strategies in discriminating between women with and without FN T-score ≤ -2.5. © 2014 American Society for Bone and Mineral Research.