Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Mar 09, 2024)
Date Submitted: Oct 14, 2023
Open Peer Review Period: Oct 13, 2023 - Oct 27, 2023
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Evaluation of a Simple Rapid Screening Tool for Osteoporosis and Vertebral Fractures in Older Men and Postmenopausal Women: a real-wold study
ABSTRACT
Background:
Early recognition and detection of osteoporosis and vertebral fractures is of great importance in improving the quality of life of the elderly. Real-world studies based on electronic health records (EHRs) and large data samples can inform the lack of screening tools for osteoporosis and vertebral fractures in older men and postmenopausal women.
Objective:
The purpose of this study was to investigate the role of OSTA index in screening for primary osteoporosis and vertebral fracture (VF) in older men and postmenopausal women in a real-world study.
Methods:
A total of 6313 men and 7762 women aged 60 years or older from six districts in Shanghai were recruited and all subjects underwent X-ray examination who were divided into VF group and non-VF groups. 52425 subjects with electronic health records including 14968 primary osteoporosis and 37457 non-osteoporosis were also included in this study. Subjects with an OSTA index ≥-1 were classified as the low risk group, and those with an index <-1 were classified as the increased risk group. Logistic regression models, trend test and restricted cubic spline curves were used to examine the association between OSTA index and the prevalence of primary osteoporosis and VF. We determined the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve for osteoporosis and VF.
Results:
For community-based subjects, the prevalence of VF was 17.2%, with 17.0% in men and 17.3% in women. OSTA index showed a linear negative correlation with the presence of primary osteoporosis and VF (P for non-linearity>0.05). The area under the ROC curves of the OSTA index to identify osteoporosis in men and postmenopausal women were 71.2% and 75.3%, respectively, while the sensitivity were 74.5% and 87.9%, respectively. With regard to VF, the area under the ROC curve was about 54.2% to 66.5%, which indicates lower screening efficacy.
Conclusions:
This study is the largest sample real-world study to investigate the role of the OSTA index in screening for osteoporosis and VFs in elderly population, especially in men. These findings suggests that OSTA index might aid in the identification of the elderly population at high osteoporosis and fracture risk, and in particular to provide clinical evidence for the use of OSTA tool in primary care units. Clinical Trial: ChiCTR2100047269
Citation
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