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Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women

Authors
 Sun Min Oh  ;  Byung-Ho Nam  ;  Yumie Rhee  ;  Seong-Hwan Moon  ;  Deog Young Kim  ;  Dae Ryong Kang  ;  Hyeon Chang Kim 
Citation
 Journal of Bone and Mineral Metabolism, Vol.31(4) : 423-432, 2013 
Journal Title
 Journal of Bone and Mineral Metabolism 
ISSN
 0914-8779 
Issue Date
2013
MeSH
Aged ; Bone Density ; Female ; Humans ; Middle Aged ; Models, Biological* ; Osteoporosis, Postmenopausal/epidemiology* ; Osteoporosis, Postmenopausal/physiopathology ; Practice Guidelines as Topic ; Regression Analysis ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment* ; Risk Factors
Keywords
Aged ; Bone Density ; Female ; Humans ; Middle Aged ; Models, Biological* ; Osteoporosis, Postmenopausal/epidemiology* ; Osteoporosis, Postmenopausal/physiopathology ; Practice Guidelines as Topic ; Regression Analysis ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment* ; Risk Factors
Abstract
Currently, dual-energy X-ray absorptiometry (DXA) is the gold standard for detecting osteoporosis, but is not recommended for general population screening. Therefore, this study aims to develop an osteoporosis risk-assessment model to identify high-risk individuals among Korean postmenopausal women. Data from 1,209 and 1,046 postmenopausal women who participated in the 2009 and 2010 Korean National Health and Nutrition Examination Survey, respectively, were used for development and validation of an osteoporosis risk-assessment model. Osteoporosis was defined as T score less than or equal to -2.5 at either the femoral neck or lumbar spine. Performance of the candidate models and the Osteoporosis Self assessment Tool for Asians (OSTA) were compared with respect to sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). To compare the developed Korean Osteoporosis Risk-Assessment Model (KORAM) with OSTA, a net reclassification improvement was further calculated. In the development dataset, the prevalence of osteoporosis was 33.9 %. KORAM, consisting of age, weight, and hormone therapy, had a sensitivity of 91.2 %, a specificity of 50.6 %, and an AUC of 0.709 with a specific cut-off score of -9. Comparable results were shown in the validation dataset: sensitivity 84.8 %, specificity 51.6 %, and AUC 0.682. Additionally, risk categorization with KORAM showed improved reclassification over that of OSTA from 7.4 to 41.7 %. KORAM can be easily used as a pre-screening tool to identify candidates for DXA tests. Further studies investigating cost-effectiveness and replicability in other datasets are required to establish the clinical utility of KORAM.
Full Text
http://link.springer.com/article/10.1007%2Fs00774-013-0426-0
DOI
10.1007/s00774-013-0426-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deog Young(김덕용) ORCID logo https://orcid.org/0000-0001-7622-6311
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Moon, Seong Hwan(문성환)
Oh, Sun Min(오선민)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87444
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