scholarly journals Performance of quantitative ultrasound and six osteoporosis risk indexes in menopausal women: Validation and comparative evaluation study

2016 ◽  
Vol 3 (2) ◽  
pp. 40-46
Author(s):  
Imad Ghozlani ◽  
Aziza Mounach ◽  
Mirieme Ghazi ◽  
Radouane Niamane ◽  
Abdellah El Maghraoui
Keyword(s):  
Sensitivity And Specificity ◽  
Quantitative Ultrasound ◽  
Assessment Tool ◽  
Negative Likelihood Ratio ◽  
Evaluation Study ◽  
Screening Tools ◽  
Mineral Density ◽  
Total Hip ◽  
T Score ◽  
Ability To Act

Background: A number of questionnaire-based systems and the use of portable quantitative ultrasound scanners (QUS) have been devised in an attempt to produce a cost-effective method of screening for osteoporosis. Objective: to assess the sensitivity and specificity of different techniques and their ability to act as screening tools in relation to dual energy X-ray absorptiometry (DXA). Methods: 295 white postmenopausal women aged over 60 were enrolled. Each subject completed a standardized questionnaire which permits the measure of six osteoporosis indexes and had bone mineral density (BMD) measured using QUS and DXA. Sensitivity and specificity of the different techniques in relation to DXA were plotted as receiver-operating characteristic (ROC) curves at DXA T-score total hip ≤ -2.5 (osteoporosis). Results: BUA sensitivity and specificity values were respectively 76.8% and 51.2% at the total hip. The optimal cut-off T-score for QUS was -2 at the total hip. The osteoporosis self-assessment tool (OST) provided consistently the highest AUC (0.80) among the clinical tools and had the best sensitivity and specificity balance (90.2%-44.5%). OST negative likelihood ratio was 0.22. Conclusion: OST (based only on the weight and the age) performed slightly better than QUS and other risk questionnaires in predicting low BMD at the total hip

scholarly journals Performance of osteoporosis self-assessment tool in detecting low bone mineral density in menopausal women

2017 ◽  
Vol 36 (2) ◽  
pp. 123 ◽  
Author(s):  
Ignatio Rika Haryono ◽  
Nawanto Agung Prastowo
Keyword(s):  
Bone Mineral Density ◽  
High Risk ◽  
Diagnostic Performance ◽  
Assessment Tool ◽  
Mineral Density ◽  
Self Assessment ◽  
Total Hip ◽  
T Score ◽  
Menopausal Women ◽  
Hip Bmd

<p>Background<br />The osteoporosis self-assessment tool (OST) is a simple screening tool to assess risk of osteoporosis and to select high risk women for dual-energy x-ray absorptiometry (DXA) examination. This study aimed to evaluate OST performance in detecting low bone mineral density (BMD) in menopausal women.</p><p>Methods<br />A cross-sectional study involving 60 menopausal women aged 50-65 years. The OST score was calculated from: [weight (kg) – age (yr)] x 0.2. Subjects were classified by OST score into low risk (OST ³2) and high risk (OST&lt; 2) groups. BMD was determined by DXA at 3 bone locations (L1-L4, femoral neck, and total hip). DXA T-scores were categorized into: normal BMD (T-score &gt;-1) and low BMD (T-score £-1). Independent t-test was used to compare subject characteristics between OST groups. Diagnostic performance of OST was evaluated by measuring sensitivity, specificity, positive &amp; negative predictive value (PPV, NPV), positive &amp; negative likelihood ratio (PLR, NLR) and receiver-operating characteristic (ROC). Significance was set at p&lt;0.05.</p><p>Results<br />Subject characteristics and BMD between groups were significantly different (p&lt;0.05). Most subjects (44/73.3%) had high risk of low BMD (OST &lt; 2). Low BMD (T score £-1) was found in 43 subjects (71.7%) at L1-L4, 41 subjects (68.3%) at femoral neck, and 37 subjects (61.7%) at total hip. Diagnostic performance of OST was significant at total hip BMD (sensitivity=0.946, AUC=0.777).</p><p>Conclusion <br />We conclude that use of the OST score in menopausal women is effective and has adequate sensitivity and specificity. The highest diagnostic performance of OST is on total hip BMD.</p>

scholarly journals Osteoporosis Self Assessment Tool for Asian (OSTA) Index in Comparison to Quantitative Ultrasound of the Calcaneal in Predicting Low Bone Density.

2014 ◽  
Vol 3 (2) ◽  
pp. 20-25 ◽  
Author(s):  
Binod Sherchan ◽  
Arjun Lamichhane ◽  
Deepak Prakash Mahara
Keyword(s):  
Bone Density ◽  
Diagnostic Accuracy ◽  
Quantitative Ultrasound ◽  
Assessment Tool ◽  
Screening Methods ◽  
Mineral Density ◽  
Self Assessment ◽  
T Score ◽  
Low Bone Density ◽  
Sensitivity Specificity

Introduction: Osteoporosis represent a worldwide public health problem, frequently resulting in fractures and leading to psychological problem, social consequences, functional limitation and poor quality of life. So it is important to identify those people who have high risk of osteoporosis, in order to reduce the incidence of osteoporotic fractures. The Osteoporosis Self-Assessment Tool for Asians (OSTA) index is a simple tool based on age and body weight. Calcaneal quantitative ultrasound (QUS) is another simple and low-cost instrument used to prescreen osteoporotic subjects. The aim of this study was to correlate between these two screening methods and to validate usefulness of Osteoporosis self assessment tool for Asian ( OSTA) in comparison with QUS of the calcaneum for the prediction of low bone density in Nepalese women. Methods: This was a two-year descriptive observational study comprising 100 subjects performed at TU Teaching Hospital, Kathmandu, Nepal, from 2007 January to 2009 January who completed semi structured questionnaire with subsequent measurement of Quantitative Ultrasound (QUS) of the calcaneum. The sensitivity, specificity, and diagnostic accuracy of OSTA index was validated with the QUS T-score. Results: When the risk category was defined as OSTA index ≤ -1, and low QUS value as t-score ≤ -2.5, the sensitivity, specificity and diagnostic accuracy of the index were 93.3%, 56.5%, and 62% respectively, and the area under the curve was 0.7651. When the low QUS value was taken as t score ≤ -1.0, the sensitivity, speciÞ city and diagnostic accuracy was 85.2%, 89.1% and 87% respectively. Conclusions: The OSTA index, a simple and free risk assessment tool, can be used to estimate the prevalence of low QUS values in Nepalese women and may help to increase awareness and prevention of low bone mineral density. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9524  NOAJ July-December 2013, Vol 3, Issue 2, 20-25

scholarly journals A Model of BMD Changes After Alendronate Discontinuation to Guide Postalendronate BMD Monitoring

2014 ◽  
Vol 99 (11) ◽  
pp. 4094-4100 ◽  
Author(s):  
Brian McNabb ◽  
Eric Vittinghoff ◽  
Richard Eastell ◽  
Ann V. Schwartz ◽  
Douglas C. Bauer ◽  
...  
Keyword(s):  
Multicenter Clinical Trial ◽  
Intervention Trial ◽  
Mineral Density ◽  
Management Change ◽  
Total Hip ◽  
T Score ◽  
Hip Bmd ◽  
The Given

Context: Women stopping alendronate are commonly monitored with serial bone mineral density (BMD) measurements, yet no information exists on how frequently or for whom these measurements should be performed. Objective: The objective of the study was to develop a tool to guide post-alendronate BMD monitoring. Design: A predictive model was constructed to estimate the time until a given percentage of women's BMD T-scores drop below a given threshold that indicates a management change (such as retreatment) would be considered. This model was then used to estimate the time it would take for groups of women defined by their baseline BMDs to drop below the given threshold. Setting: Data were derived from the Fracture Intervention Trial Long Term Extension (FLEX), the largest multicenter clinical trial of its type to date. Participants: Four hundred four women who had received an average of 5.1 years of alendronate during the Fracture Intervention Trial and were subsequently observed for 5 treatment-free years (on placebo) during the FLEX trial were used to estimate the change in BMD over time. Results: If a management change such as alendronate reinitiation would be considered when BMD T-score drops below −2.5, the model shows that women with total hip BMD greater than −1.9 T-scores at the time of alendronate discontinuation have less than a 20% probability that at follow-up, monitoring BMD will be below the threshold within 5 years. The model performed similarly, and results are provided over a range of management change thresholds from −1.75 to −3 T-scores. Conclusions: Using the tool developed in this analysis, it is possible to estimate when BMD repeat measurement after alendronate discontinuation could potentially be useful. Measuring BMD within 5 years after alendronate discontinuation is unlikely to change management for women with total hip BMD 0.6 T-scores above a prespecified retreatment threshold within the range of −1.75 to −3 T-scores.

scholarly journals Comparison of osteoporotic fracture risk in surgical and natural menopausal patients

2021 ◽  
Vol 67 (3) ◽  
pp. 322-327
Author(s):  
Ayça Utkan Karasu ◽  
Yetkin Karasu ◽  
Müzeyyen Gülnur Özakşit ◽  
Yusuf Üstün ◽  
Yaprak Üstün Engin
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Assessment Tool ◽  
Lumbar Vertebrae ◽  
Mineral Density ◽  
Natural Menopause ◽  
T Score ◽  
Surgical Menopause

Objectives: This study aims to compare the fracture risk calculated with Fracture Risk Assessment Tool (FRAX®) in patients with natural and surgical menopause. Patients and methods: Between April 2019 and July 2019, 285 postmenopausal patients (mean age 57.3 years; range, 40 to 78 years) who were admitted to the menopause clinic were enrolled in this prospective cross-sectional study. Of these, 220 were in natural menopause and 65 were in surgical menopause. Demographic data, medical history, and International Physical Activity Questionnaire scores were collected through face-to-face interviews with the patients. Femoral neck and lumbar vertebrae (L1-L4) T-scores were evaluated using dual-energy X-ray absorptiometry. Fragility fracture risk was assessed using FRAX®. Results: The groups were similar in terms of age, body mass index, duration of menopause, smoking, alcohol use, and history of fracture (p>0.05). The risk of major osteoporotic fracture and hip fracture calculated without adding bone mineral density (BMD) was similar between groups (p=0.417 and p=0.234). The risk of hip fracture calculated with the addition of BMD was higher in natural menopause patients (p=0.023). Lumbar vertebrae T-scores were similar between two groups regardless of age; femoral neck T-scores were higher in surgical menopause (T-score=-0.8) than natural menopause group (T-score=-1.25) aged under 60 years, whereas this difference disappeared after 60 years of age. Conclusion: In our study, the fracture risk and the severity of osteoporosis were not different in surgical menopausal patients compared to the natural menopausal patients. Hip fracture risk calculated using BMD was lower in patients under 50 years of age in surgical menopausal patients. However, the fracture risks were similar in both groups after 50 years of age.

Sensitivity and Specificity Analysis: Use of Emoticon for Screening of Depression in Elderly in Singapore

2018 ◽  
Vol 24 (5) ◽  
pp. 452-456 ◽  
Author(s):  
Laurence Tan ◽  
Hui Jin Toh ◽  
Lai Kiow Sim ◽  
James Alvin Low
Keyword(s):  
Sensitivity And Specificity ◽  
English Language ◽  
Assessment Tool ◽  
The Elderly ◽  
Screening Tools ◽  
Cutoff Score ◽  
Care Hospital ◽  
Cross Sectional ◽  
Dsm Iv ◽  
Cutoff Scores

BACKGROUND: The current screening tools for depression can be tedious to administer, especially in the elderly population with hearing impairment and/or limited proficiency in English language. OBJECTIVES: To look at the feasibility of using emoticon as a screening and assessment tool for depression in the elderly. DESIGN: Cross-sectional study. METHOD: A total of 77 elderly patients completed the study from June 2014 to August 2015 in a general geriatric outpatient clinic of an acute care hospital in Singapore. Patients rated their mood using an emoticon scale, which ranges from 1 ( most happy face) to 7 ( most sad face). Depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria as the gold standard. Sensitivity and specificity for depression were calculated for the cutoff scores from 1 to 7 on the emoticon scale. RESULTS: The sensitivity percentages were low across all cutoff scores. The specificity was more than 90% for the cutoff score of 5 and above on the emoticon scale. However, all the patients who had depression diagnosed using the DSM-IV criteria did not have emoticon scores of 5 and above. CONCLUSIONS: The emoticon scale was easy to use, but its effectiveness in the screening of depression in the elderly needs to be explored further. The inability to use the emoticon scale as a tool may be the lack of measurements in the other domains of the DSM-IV criteria (sleep, energy, appetite, etc.), rather than failure of the emoticon scale to assess mood.

scholarly journals Comparison of T-score values obtained by ultrasound osteodensitometry of calcaneus and by dual-energy x-ray absorptiometry scan

2015 ◽  
Vol 68 (9-10) ◽  
pp. 341-346
Author(s):  
Aleksandra Hadziavdic ◽  
Natasa Vajic ◽  
Nikola Gavric
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Metabolic Disease ◽  
Quantitative Ultrasound ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
Female Patients ◽  
T Score ◽  
Significant Difference

Introduction. Osteoporosis is the most frequent metabolic disease of bones. Early detection of pathological loss of bone mineral density represents the first step in prevention, treatment and rehabilitation of osteoporosis. This study was aimed at establishing the correlation of T-score values obtained by ultrasound osteodensitometry of calcaneus with dual-energy x-ray absorptiometry scan. Material and Methods. The study was conducted on the sample of 569 female patients from September 13, 2010 to March 10, 2011. Measurement was made with ultrasound osteodensitometry of ACHILLES make. Quantitative ultrasound method revealed that 77 female patients had a lower value of T-score (osteopenia with risk factors or osteoporosis) and they were referred to T-score measurement with dual-energy x-ray absorptiometry scan. Dual-energy x-ray absorptiometry scanning was performed using LUNAR DPX scanner and 49 female patients were examined. Results. It was concluded that there was no statistically significant difference between T-score values obtained by quantitative ultrasound and dual-energy x-ray absorptiometry scanning. Conclusion. According to this study, it is necessary to provide a greater number of scanners for ultrasound osteodensitometry of calcaneus in order to secure prevention and to refer the patients to further diagnosing on time.

Comparison of FRAX score to bone mineral density for estimating fracture risk in patients with CRPC on androgen-deprivation therapy (ADT).

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 101-101
Author(s):  
Marc Nicolas Bienz ◽  
Herbert James ◽  
Ilija Aleksic ◽  
Christopher Michael Pieczonka ◽  
David Albala ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Assessment Tool ◽  
Significant Risk ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Fracture Risk Assessment Tool ◽  
Frax Score ◽  
Treatment Table ◽  
Country Specific

101 Background: A FRAX algorithm has been elaborated to estimate the ten-year hip fracture risk associated with this under-diagnosed condition. We aim to evaluate the fracture risk of patients who would otherwise be left untreated by the conventional T-score. Methods: Clinical data from 613 PCa patients undergoing ADT was collected from our AMP large urology group. Fracture risk was assessed using the country specific (USA) Fracture Risk Assessment Tool (FRAX). Also, a subset of patients (n=94) had received Dual-energy X-ray Absorptiometry (DXA). We compared the proportion of patients suitable for treatment according to the threshold of the FRAX fracture risk calculated with the BMD (>3%) and the T-score (<-2.5). Results: According to the FRAX algorithm (without BMD), 61.6% of our cohort require treatment. The FRAX score (with BMD) identified 46.8% of patients who had DXA suitable for treatment, in contrast to 19.1% by the T-score alone. Correlations were calculated between the various methods (Table). Conclusions: Our results demonstrate that many patients unidentified for treatment by the conventional T-score are at significant risk for fracture according to the FRAX algorithm with BMD. When calculated without the BMD, an even greater proportion of patients is found to be at risk and suitable for treatment. [Table: see text]

scholarly journals Comparative studies of bone density by quantitative ultrasound (QUS) with dual-energy X-ray absorptiometry (DEXA) scan

2019 ◽  
Vol 9 (1) ◽  
pp. 8-12
Author(s):  
Alark Devkota Rajouria ◽  
Madur Dev Bhattarai ◽  
Manil Ratna Bajracharya ◽  
Buddha Bahadur Karki
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Quantitative Ultrasound ◽  
Screening Tool ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorp­tiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis. Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius. Results: Significant correlations were observed between QUS and DEXA T score. Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.

scholarly journals The Impact of the “Osteo” Component of Osteosarcopenia on Fragility Fractures in Post-Menopausal Women

2021 ◽  
Vol 22 (10) ◽  
pp. 5256
Author(s):  
Yen-Huai Lin ◽  
Yu-Tai Shih ◽  
Michael Mu Huo Teng
Keyword(s):  
Fracture Risk ◽  
Assessment Tool ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Mineral Density ◽  
High Fracture ◽  
T Score ◽  
Menopausal Women ◽  
Post Menopausal ◽  
The Impact

Osteosarcopenia, the coexistence of bone and muscle loss, is common in older adults, but its definition lacks international consensus. This cross-sectional study (n = 1199 post-menopausal women) aimed to determine the association between osteosarcopenia and fragility fractures and to investigate the impact of the definition of the “osteo” component. Bone mineral density and bone microarchitecture were measured by dual-energy X-ray absorptiometry and the trabecular bone score (TBS), respectively. The “osteo” component of osteosarcopenia was classified as osteoporosis (T-score ≤ −2.5 SD), osteopenia/osteoporosis (T-score < −1 SD), and high-fracture-risk osteopenia (−2.5 SD < T-score < −1 SD)/osteoporosis (T-score ≤ −2.5 SD). The Fracture Risk Assessment Tool was used to identify high-fracture-risk osteopenia. Altogether, 30.3%, 32.2%, 14.4%, and 23.1% of participants had osteosarcopenia, osteoporosis alone, sarcopenia alone, and neither condition, respectively. The odds ratios between osteosarcopenia and fragility fractures were 3.70 (95% CI: 1.94–7.04) for osteosarcopenia, 2.48 (95% CI: 1.30–4.71) for osteoporosis alone, and 1.87 (95% CI: 0.84–4.14) for sarcopenia alone. Women with osteosarcopenia also had lower TBS, indicating worse bone microarchitecture. In conclusion, women with osteosarcopenia were more likely to have previously sustained a fracture compared to those without osteosarcopenia, with sarcopenia alone, and with osteoporosis alone. The relationship between osteosarcopenia and fracture risk may be best identified when considering high-fracture-risk osteopenia and osteoporosis.

scholarly journals AB0617 BISPHOSPHONATES DANS L’OSTÉOPOROSE ET LE RISQUE D’OSTÉONÉCROSE DE LA MÂCHOIRE, ENVIRON 896 CAS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1343.1-1343
Author(s):  
A. R. Halidou ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Corticosteroid Therapy ◽  
Osteonecrosis Of The Jaw ◽  
Mineral Density ◽  
Duration Of Treatment ◽  
Treatment Of Osteoporosis ◽  
Total Hip ◽  
T Score

Background:Bisphosphonates (BF) are used in the treatment of osteoporosis, Paget’s disease of bone, hypercalcemia and in patients with cancer. When used to treat osteoporosis, the optimal duration of treatment is 3 to 5 years; however, their long-term use has been rarely associated with osteonecrosis of the jaw.Objectives:To assess the risk of developing osteonecrosis of the jaw in patients followed for osteoporosis and on bisphosphonates (BP).Methods:Type of study: retrospective study conducted at the rheumatology department of the IBN ROCHD CHU in Casablanca.Duration: from October 2013 to October 2020 (7 years).Inclusion criteria: all patients followed for osteoporosis in the weakening osteopathies unit of the bone and treated with oral or intravenous bisphosphonates.Exclusion criteria: patients followed for other than osteoporosis.Results:896 patients were treated during this period. The average age was 62.74 years (28 to 90 years), of which 85.16% were women and 14.84% were men, for a sex ratio (F / M) of 5.74. As a history, 18.75% of patients are diabetic, 26.56% followed for breast neoplasm, 14.06% of patients had received long-term corticosteroid therapy for various pathologies such as chronic inflammatory rheumatism. Osteoporosis was postmenopausal in 687 patients, ie 76.67% of cases, 14.06% after long-term corticosteroid therapy, 8.15% following hormone therapy (anti-aromatases) and 6.92% following chemotherapy; note that 18.16% of these patients were found in at least two of the situations. The mean bone mineral density (BMD), T-score pair considered in all [T-score (BMD)] is -3 (0.736) in the lumbar spine (L1-L4), -2.9 (0.658) at the femoral neck, -2.6 (0.804) at the total hip before the start of treatment. 69.97% of the patients were put on Alendronic acid, 12.50% on Residronic acid, 10.93% on Zolidronic acid, 3.46% on Pamidronic acid and 3.14% received Strontium Ranelate, note that before the start of the treatment all the patients benefited from a dental consultation followed by care of any lesions, the bisphosphonates were only introduced after having ruled out all their dental contraindications, the average duration of treatment for all the molecules was 4.71 years (2 to 5 years) and no patient developed osteonecrosis of the jaw. The change in control BMD on average after 2 years of treatment was -2.7 (0.782) at the lumbar spine, -2.6 (0.749) at the femoral neck and -2.4 (0.713) at the hip total, after 5 years -2.4 (0.874) at the spine, -2.1 (0.809) at the femoral neck and -1.93 (861) at the total hip.Conclusion:The occurrence of ONJ in the treatment of osteoporosis with the use of BFs is rare, and appears to be unpredictable; but maintaining therapeutic caution, consisting in diagnosing and treating any dental lesions before starting treatment, can considerably reduce or even cancel the risk of occurrence; especially in patients treated with long-term intravenous pamidronate.References:[1]Dr Halidou Idrissa Abdoul-Rahamane, Pr Kawtar Nassar, PR Saadia Janani.[2]Rheumatology department of the IBN ROCHD CHU in CASABLANCA. Casablanca Faculty of Medicine and Pharmacy. Hassan II University. MoroccoDisclosure of Interests:None declared.

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