Agreement between calcaneal quantitative ultrasound and osteoporosis self-assessment tool for Asians in identifying individuals at risk of osteoporosis
Received 4 July 2017
Accepted for publication 31 August 2017
Published 6 October 2017 Volume 2017:13 Pages 1333—1341
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Kok-Yong Chin,1 Nie Yen Low,2 Alia Annessa Ain Kamaruddin,2 Wan Ilma Dewiputri,2 Ima-Nirwana Soelaiman1
1Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia; 2ASASIpintar Foundation Program, PERMATApintar National Gifted Centre, Universiti Kebangsaan Malaysia, Bangi, Malaysia
Background: Calcaneal quantitative ultrasound (QUS) is a useful tool in osteoporosis screening. However, QUS device may not be available at all primary health care settings. Osteoporosis self-assessment tool for Asians (OSTA) is a simple algorithm for osteoporosis screening that does not require any sophisticated instruments. This study explored the possibility of replacing QUS with OSTA by determining their agreement in identifying individuals at risk of osteoporosis.
Methods: A cross-sectional study was conducted to recruit Malaysian men and women aged ≥50 years. Their bone health status was measured using a calcaneal QUS device and OSTA. The association between OSTA and QUS was determined using Spearman’s correlation and their agreement was assessed using Cohen Kappa and receiver-operating curve.
Results: All QUS indices correlated significantly with OSTA (p<0.05). The agreement between QUS and OSTA was minimal but statistically significant (p<0.05). The performance of OSTA in identifying subjects at risk of osteoporosis according to QUS was poor-to-fair in women (p<0.05), but not statistically significant for men (p>0.05). Changing the cut-off values improved the performance of OSTA in women but not in men.
Conclusion: The agreement between QUS and OSTA is minimal in categorizing individuals at risk of osteoporosis. Therefore, they cannot be used interchangeably in osteoporosis screening.
Keywords: bone, correlation, osteopenia, ROC, sensitivity, specificity
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