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A risk assessment tool (OsteoRisk) for identifying latin American women with osteoporosis

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Abstract

OBJECTIVE: To develop a simple and easy-to-use tool for identifying osteoporotic women (femoral neck bone mineral density [BMD] T-scores ≤−2.5) in Latin America.

DESIGN: Retrospective study involving review of medical records.

SETTING: Osteoporosis clinics in 6 Latin American countries.

PATIENTS: Postmenopausal women ages ≥50 in Latin America who had femoral neck BMD measurements.

MEASUREMENTS AND MAIN RESULTS: A risk index was developed from 1.547 patients based on least square regression using age, weight, history of fractures, and other variables as predictors for BMD T-score. The final model was simplified by reducing the number of predictors; sensitivity and specificity were evaluated before and after reducing the number of predictors to assess performance of the index. The final model included age, weight, country, estrogen use, and history of fractures as significant predictors for T-score. The resulting scoring index achieved 91% sensitivity and 47% specificity. Simplifying the index by using only age and weight yielded similar performance (sensitivity, 92%; specificity, 45%). Three risk categories were identified based on OsteoRisk, the index using only age and body weight: high-risk patients (index <=−2; 65.6% were osteoporotic), moderate-risk patients (−2<index <=1; 26.7% were osteoporotic), and low-risk patients (index>1; 8% were osteoporotic). Similar results were seen in a validation sample of 279 women in Brazil.

CONCLUSION: Age and weight alone performed well for predicting the risk of osteoporosis among postmenopausal women. The OsteoRisk is an easy-to-use tool that effectively targets the vast majority of osteoporotic patients in Latin America for evaluation with BMD.

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Author information

Authors and Affiliations

  1. Merck & Company, Inc., P.O. Box 100, 08999, Whitehouse Station, NJ

    Shuvayu S. Sen PhD

  2. Temple University School of Pharmacy, Philadelphia, PA, USA

    Vincent P. Rives PharmD

  3. Department of Rheumatology, C. Argerich Hospital, Buenos Aires, Argentina

    Osvaldo D. Messina MD

  4. Facultad de Medicina de Leon, Hospital Aranda de la Parra, León, GTO, Mexico

    Jorge Morales-Torres MD

  5. Department of Medicine, Universidad de Carabobo, Valencia, Venezuela

    Gregorio Riera MD

  6. Hospital Central de la Fuerza Aérea, Lima, Peru

    Juan M. Angulo-Solimano MD

  7. Department of Rheumatology, State University (Unicamp), Campinas, SP, Brazil

    João F. M. Neto MD

  8. Department of Internal Medicine, Universida de Federal de Sao Paulo, Sao Paulo, Brazil

    Alberto Frisoli Jr. MD

  9. Department of Medicine, Division of Rheumatology, Hospital Dr. R.A. Calderón Guardia, San José, Costa Rica

    Ricardo C. Sáenz MD

  10. Rutgers University, Piscataway, NJ, USA

    Olga Geling PhD

  11. Merck Research Laboratoires, Rahway, NJ, USA

    Philip D. Ross PhD

Authors
  1. Shuvayu S. Sen PhD
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  2. Vincent P. Rives PharmD
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  3. Osvaldo D. Messina MD
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  4. Jorge Morales-Torres MD
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  5. Gregorio Riera MD
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  6. Juan M. Angulo-Solimano MD
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  7. João F. M. Neto MD
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  8. Alberto Frisoli Jr. MD
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  9. Ricardo C. Sáenz MD
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  10. Olga Geling PhD
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  11. Philip D. Ross PhD
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Corresponding author

Correspondence to Shuvayu S. Sen PhD.

Additional information

Dr. Shuvayu S. Sen and Dr. Phillip D. Ross are employees of Merck & Company, Inc.

This study was funded in part by Merck & Company, Inc. The authors would like to acknowledge Dr. Olga Geling for her support with data analysis.

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Sen, S.S., Rives, V.P., Messina, O.D. et al. A risk assessment tool (OsteoRisk) for identifying latin American women with osteoporosis. J GEN INTERN MED 20, 245–250 (2005). https://doi.org/10.1111/j.1525-1497.2005.40900.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2005.40900.x

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