A comparison of 6 osteoporosis risk assessment tools among postmenopausal women in Kuala Lumpur, Malaysia

Toh, Li Shean; Lai, Pauline Siew Mei; Wu, David Bin-Chia; Bell, Brian; Dang, Cuu Phuong Linh; Low, Bee Yean; Wong, Kok Thong; Guglielmi, Giuseppe; Anderson, Claire

doi:10.1016/j.afos.2019.09.001

Cited by 13 publications

(7 citation statements)

References 20 publications

(37 reference statements)

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“…Recent research has shown that most of these tools were lacking precision (ranging from 0.04 to 0.12), and the simple calculated osteoporosis risk estimation (SCORE) had the best balance between recall and precision among the tested tools, and the AUC was the highest (0.072–0.161). [ 18 ] A study has tested FRAX without BMD, and they found its sensitivity to be 33.3% with a specificity of 86.4% and an AUC of 60% at a threshold of ≥9.3%,[ 19 ] while the AUC in our findings was around 90%. Ettinger et al .…”

Section: Discussionmentioning

confidence: 52%

Prevalence, risk assessment, and predictors of osteoporosis among chronic obstructive pulmonary disease patients

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Sulaiman

Ali

et al. 2021

Journal of Advanced Pharmaceutical Technology &Amp; Research

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The link between chronic obstructive pulmonary disease (COPD) and osteoporosis is unclear and yet to be understood. The study goals were to detect the prevalence of osteoporosis and investigate its predictors among COPD patients. This is a longitudinal study conducted in a tertiary care setting. During the study, patients' bone mineral density was checked, pulmonary parameters were recorded, and a risk assessment tool was validated. Based on T-score, more than 50% of subjects were osteoporotic. Spirometric parameters were significantly lower among osteoporotic patients. For the risk assessment tool, a cutoff point of 34 made the optimum balance between sensitivity and specificity (0.867 and 0.087, respectively) with a generated area under the curve of 0.934. Severe COPD patients were four times at higher risk of getting osteoporosis, forced expiratory volume (FEV) % predicted, and FEV/forced vital capacity was inversely related to the risk of osteoporosis. Patients with severe dyspnea had twice the risk of getting osteoporosis. Osteoporosis was prevalent among COPD patients, and severe COPD patients were at higher risk of getting osteoporosis.

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Section: Discussionmentioning

confidence: 52%

Prevalence, risk assessment, and predictors of osteoporosis among chronic obstructive pulmonary disease patients

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Sulaiman

Ali

et al. 2021

Journal of Advanced Pharmaceutical Technology &Amp; Research

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“…An interesting recent study demonstrated that during weight-loss programs, BMI can not specify the fat distribution, with limited use of this datum; in contrast with DXA report, which is able to quantify the metabolic re-distribution of total and regional fat mass and visceral adipose tissue [ 49 ]. Another study compared the accuracy of six different osteoporosis risk assessment tools in a restricted group of women in Kuala Lumpur, further demosntrating the importance of DXA in such context [ 50 ].…”

Section: Dxa: Beyond Bone Health Assessmentmentioning

confidence: 99%

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

et al. 2021

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Osteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

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“…The highest ethnic proportion in Singapore is the Chinese population (74.2%), while in Malaysia Bumiputera including the Malay population (approximately 70%) is the majority [ 26 , 27 ]. OSTA was found to be unsuitable to identify osteoporosis among postmenopausal women in a Malaysian study [ 28 ]. However, we need to be cautious in promoting FRAX alone as the screening modality for osteoporosis as it may or may not be cost-effective to screen with FRAX, depending on the setting [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia

Tay

Beh

et al. 2022

Arch Osteoporos

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Summary We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive attitudes towards them. We advocate for the active management of osteoporosis at the primary care level. Introduction Prevention of osteoporotic fracture is important in primary healthcare for healthy ageing. Little is known about the knowledge, attitude, practice and barriers in the screening and managing osteoporosis among primary care doctors. Methods A cross-sectional study, using an online pre-tested questionnaire after face and content validation, was conducted for primary care doctors from 1 June to 30 July 2021 across Malaysia. Pearson’s chi-square test and logistic regression were employed. Results A total of 350 primary care doctors in Malaysia, consisting of 113 (32.3%) family medicine specialists (FMS) and 237 (67.7%) medical officers, participated in this study. The mean ± SD score of osteoporosis knowledge was 50.46 ± 15.09 with minimum and maximum values of 0 and 83.64%, respectively. One hundred and ten (31.4%) respondents achieved a satisfactory overall knowledge score of ≥ 60%, 156 (44.6%) were confident in advising patients for initiation of anti-osteoporotic medication, and 243 (69.4%) perceived that bisphosphonate should be made available in health clinics. Only 97 (27.7%) practised osteoporosis screening. Inaccessibility of bone mineral densitometry (BMD) (90.6%), inadequate knowledge (87.7%) and inaccessibility of pharmacotherapy (87.1%) are perceived modifiable barriers to osteoporosis screening and management. Factors associated with a satisfactory knowledge of osteoporosis are designation as a family medicine specialist (AOR 3.034, p = 0.002), attendance at an osteoporosis management update course (AOR 2.095, p = 0.034) and the practice of osteoporosis screening for the elderly (AOR 2.767, p = 0.001). Conclusion Given the insufficient knowledge and low level of osteoporosis screening, there is a need for a national structured health programme to address the knowledge gap, increase screening practices and enhance accessibility to BMD and anti-osteoporosis medication in primary care.

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A comparison of 6 osteoporosis risk assessment tools among postmenopausal women in Kuala Lumpur, Malaysia

Cited by 13 publications

References 20 publications

Prevalence, risk assessment, and predictors of osteoporosis among chronic obstructive pulmonary disease patients

Prevalence, risk assessment, and predictors of osteoporosis among chronic obstructive pulmonary disease patients

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia

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