Validation of OSTA among Filipinos

Abstract

Osteoporosis is the most common metabolic bone disease in humans. It is a special concern not only among postmenopausal women, but men as well. In developing countries where there are meager resources, it will definitely be helpful to search for ways to identify patients with low bone mineral density who have a high risk of future fractures. These people need to be identified for treatment consideration in order to reduce the incidence of the disease and its complications. A simple risk index called the Osteoporosis Screening Tool for Asians (OSTA), based only on two variables, age and body weight, performed well in identifying the risk of osteoporosis among postmenopausal women. This index has been validated in Japan, Korea and other Caucasian populations as a useful tool in identifying individuals who will require BMD measurement. This is the first study that validated the said index in 1,597 Filipino women and men referred to a tertiary center for BMD measurement. It had sensitivity of 97 and 90% and specificity of 59 and 66% with areas under the curve of 0.8506 and 0.8475, respectively, for women and men. We conclude that OSTA performed just as well or even better than other indices used in other populations to identify individuals who are at varying degrees of risk for osteoporosis. The tool also proves to be a useful and practical guide to help clinicians to be more prudent and judicious in employing bone mineral density measurement.

Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

“…Several previous studies defined osteoporosis by a T-score ≤ −2.5 at the femoral neck for establishment of OSTA [9, 18, 19, 21]. However, based on BMD measured at different skeletal sites, our data showed that the accuracy for OSTAi was somewhat diverse.…”

“…Prevalence of osteoporosis for high-risk group by OSTA risk category in several Asian studies, including multi-country sample of Asian women[9], Korea[19], Filipinos[21], China[23] were 61%, 64%, 51.3%, and 44%, respectively. As the cutoff index values of each study were arbitrary, to compare the prevalence of osteoporosis of each country/population in each category seems not feasible.…”

“…In addition, it was well known that osteoporosis at any site can predict future fracture risk at other site [32]. Therefore, as the study by Yang et al [23] and in Saraví FD research [33], we developed OSTAi for identifying possible osteoporosis according to T-score ≤ -2.5 at any site, instead of the femoral neck in other studies [9, 18, 19, 21]. …”

The effect of age on the changes in bone mineral density and osteoporosis detection rates in Han Chinese men over the age of 50

“…Further studies on post-menopausal women in South Korea, China, Thailand, the Philippines and other Asian countries revealed sensitivity and specificity in the range of 87-97.5% and 54.6-60.8%, respectively [9][10][11]. However, there are relatively fewer studies in Asian men populations, and the limited available data suggest that for a cutoff of OSTA À1, the sensitivity ranges from 70 to 90% with 70% specificity [8,12].…”

Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

“…The easier to use in clinical practice are certainly the osteoporosis self-assessment tool [3,27] and the body weight criterion [19]. They have been validated for women of diverse origins, including Asian and Caucasian [3,[28][29][30][31][32]. The evidence for the utility of these rules in a clinical setting is scarce and few studies have been performed in men [33][34][35][36][37][38][39][40].…”