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

Sun Min Oh, Byung Ho Nam, Yumie Rhee, seonghwan moon, Deog Young Kim, Dae Ryong Kang, HyeonChang Kim

Research output: Contribution to journalArticle

16 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)423-432
Number of pages10
JournalJournal of Bone and Mineral Metabolism
Volume31
Issue number4
DOIs
Publication statusPublished - 2013 Jul 1

Fingerprint

Osteoporosis
Area Under Curve
Photon Absorptiometry
Sensitivity and Specificity
Nutrition Surveys
Femur Neck
ROC Curve
Cost-Benefit Analysis
Spine
Hormones
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology

Cite this

@article{4817051aa8db45c4b168736e35ab1e48,
title = "Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women",
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.",
author = "Oh, {Sun Min} and Nam, {Byung Ho} and Yumie Rhee and seonghwan moon and Kim, {Deog Young} and Kang, {Dae Ryong} and HyeonChang Kim",
year = "2013",
month = "7",
day = "1",
doi = "10.1007/s00774-013-0426-0",
language = "English",
volume = "31",
pages = "423--432",
journal = "Journal of Bone and Mineral Metabolism",
issn = "0914-8779",
publisher = "Springer Japan",
number = "4",

}

Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women. / Oh, Sun Min; Nam, Byung Ho; Rhee, Yumie; moon, seonghwan; Kim, Deog Young; Kang, Dae Ryong; Kim, HyeonChang.

In: Journal of Bone and Mineral Metabolism, Vol. 31, No. 4, 01.07.2013, p. 423-432.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women

AU - Oh, Sun Min

AU - Nam, Byung Ho

AU - Rhee, Yumie

AU - moon, seonghwan

AU - Kim, Deog Young

AU - Kang, Dae Ryong

AU - Kim, HyeonChang

PY - 2013/7/1

Y1 - 2013/7/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84880304936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880304936&partnerID=8YFLogxK

U2 - 10.1007/s00774-013-0426-0

DO - 10.1007/s00774-013-0426-0

M3 - Article

C2 - 23420298

AN - SCOPUS:84880304936

VL - 31

SP - 423

EP - 432

JO - Journal of Bone and Mineral Metabolism

JF - Journal of Bone and Mineral Metabolism

SN - 0914-8779

IS - 4

ER -