We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
PERFORMANCE OF DECISION ALGORITHMS FOR THE IDENTIFICATION OF LOW HONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN.
- Authors
Machado, Pedro; da Silva, José António Pereira
- Abstract
Although several algorithms have been proposed to select postmenopausal women (PMW) for dual-energy x-ray absorptiometry (DEXA) measurements, information on their utility in clinical practice is scarce. Our aim was to assess the utility and the economic repercussion of the use of five of these algorithms in Portuguese postmenopausal women. Methods: We included 588 PMW and selected five simple algorithms: ORAl, ABONE, Body Weight Criterion, OSTA and a modified version of OSTA (OST). Sensitivities, specificities, predictive values, areas under the receiver operating characteristic curve (AUROC) and economic estimates were computed. Results: Sensitivities ranged between 71.2%-80.8% and AUROC between 0.611-0.674. In PMW aged ≥65 years (Y), the use of any of the algorithms would cause extra costs or a residual saving. In PMW aged ≥55 and <65Y, considering total savings, ABONE had the best performance, but considering savings per preventable fracture, ORAl assumed the lead, followed by BWC. In the age group ≥40 and <55Y, the most profitable option considering total savings would be not doing DEXA to anyone; considering savings per preventable fracture, BWC figures as the most useful. Conclusions: This study provides evidence for the validity of all the selected tools as useful algorithms to select PMW for DEXA. On the basis of our results and considering the importance of simplicity in the applicability of an algorithm, we would suggest the following strategy in Portuguese PMW: 1) Aged ≥65Y: perform DEXA irrespective of other risk factors. 2) Aged <65Y: perform DEXA if body weight <70Kg.
- Subjects
PORTUGAL; ALGORITHMS; OSTEOPOROSIS in women; ABSORPTIOMETER; BONE density; BONE diseases; MENOPAUSE; OVERWEIGHT persons; DISEASE risk factors
- Publication
Acta Reumatológica Portuguesa, 2008, Vol 33, Issue 3, p314
- ISSN
0303-464X
- Publication type
Article