A comparison of six osteoporosis risk assessment tools among postmenopausal women in Kuala Lumpur, Malaysia

Shean Toh, Li; Lai, Pauline Siew Mei; Wu, David Bin-Chia; Bell, Brian G.; Dang, Cuu Phuong Linh; Low, Bee Yean; Wong, Kok Thong; Guglielmi, Giuseppe; Anderson, Claire

Abstract

Objectives
To compare and assess the performance of 6 osteoporosis risk assessment tools for screening osteoporosis in Malaysian postmenopausal women.

Methods
Six osteoporosis risk assessments tools (the Simple Calculated Osteoporosis Risk Estimation [SCORE], the Osteoporosis Risk Assessment Instrument, the Age Bulk One or Never Estrogen, the body weight, the Malaysian Osteoporosis Screening Tool, and the Osteoporosis Self-Assessment Tool for Asians) were used to screen postmenopausal women who had not been previously diagnosed with osteoporosis/osteopenia. These women also underwent a dual-energy X-ray absorptiometry (DXA) scan to confirm the absence or presence of osteoporosis.

Results
A total of 164/224 participants were recruited (response rate, 73.2%), of which only 150/164 (91.5%) completed their DXA scan. Sixteen participants (10.7%) were found to have osteoporosis, whilst 65/150 (43.3%) were found to have osteopenia. Using precision-recall curves, the recall of the tools ranged from 0.50 to 1.00, whilst precision ranged from 0.04 to 0.14. The area under the curve (AUC) ranged from 0.027 to 0.161. The SCORE had the best balance between recall (1.00), precision (0.04–0.12), and AUC (0.072–0.161).

Conclusions
We found that the SCORE had the best balance between recall, precision, and AUC among the 6 screening tools that were compared among Malaysian postmenopausal women.

Citation

Shean Toh, L., Lai, P. S. M., Wu, D. B.-C., Bell, B. G., Dang, C. P. L., Low, B. Y., Wong, K. T., Guglielmi, G., & Anderson, C. (2019). A comparison of six osteoporosis risk assessment tools among postmenopausal women in Kuala Lumpur, Malaysia. Osteoporosis and Sarcopenia, 5(3), 87-93. https://doi.org/10.1016/j.afos.2019.09.001

• Journal Article Type: Article
• Acceptance Date: Sep 3, 2019
• Online Publication Date: Sep 11, 2019
• Publication Date: Sep 11, 2019
• Deposit Date: Oct 1, 2019
• Publicly Available Date: Oct 2, 2019
• Journal: Osteoporosis and Sarcopenia
• Electronic ISSN: 2405-5255
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 3
• Pages: 87-93
• DOI: https://doi.org/10.1016/j.afos.2019.09.001
• Keywords: Osteoporosis; Screening; Osteoporosis self-assessment tool for asians; Risk assessment; Performance comparison
• Public URL: https://nottingham-repository.worktribe.com/output/2473771
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2405525519300159
• Contract Date: Oct 2, 2019