Postmenopausal bone density referral decision rules: correlation with clinical fractures. Mil Med 2004 Dec;169(12):1000-4
Date
01/14/2005Pubmed ID
15646195DOI
10.7205/milmed.169.12.1000Scopus ID
2-s2.0-13744252500 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
OBJECTIVE: To test decision rules for bone mineral density (BMD) against fractures.
METHODS: We surveyed postmenopausal women in a military primary care clinic and tested three national clinical decision rules (Osteoporosis Risk Assessment Instrument; age, body size, no estrogen; weight) for correlation with fracture history. Outcome measures included relative risk (RR), area under the receiver operating characteristics curve (aROC), sensitivity, and specificity.
RESULTS: Patients were 69 years old on average, 53% were Caucasian, 38% were African American, and 15% had a history of fractures. Caucasian women (RR, 1.8; 95% confidence interval [CI], 1.1-3.1) and those older than 65 years (RR, 2.0; 95% CI, 1.2-3.5) had higher prevalence of fractures. The Osteoporosis Risk Assessment Instrument decision rule had the highest aROC (0.65; 95% CI, 0.57-0.731 and sensitivity (sensitivity, 0.83; specificity, 0.31). Age, Body Size, No Estrogen had the next highest aROC (0.63; 95% CI, 0.54-0.71) and sensitivity (sensitivity, 0.74; specificity, 0.46). Weight criterion was the most specific (aROC, 0.60; 95% CI, 0.52-0.68; sensitivity, 0.64; specificity, 0.56).
CONCLUSIONS: Current postmenopausal bone density referral decision rules only modestly correlate with clinical fractures.
Author List
Wei GS, Jackson JLAuthor
Jeffrey L. Jackson MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Absorptiometry, PhotonAged
Decision Making
Female
Fractures, Bone
Hospitals, Military
Humans
Maryland
Middle Aged
Osteoporosis
Postmenopause
Predictive Value of Tests
Referral and Consultation
Risk Assessment
Sensitivity and Specificity
Surveys and Questionnaires
United States
