Calcaneal quantitative ultrasound and phalangeal radiographic absorptiometry alone or in combination in a triage approach for assessment of osteoporosis: a study of older women with a high prevalence of falls.
Calcaneal quantitative ultrasound and phalangeal radiographic absorptiometry alone or in combination in a triage approach for assessment of osteoporosis: a study of older women with a high prevalence of falls.
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DOI：
10.1186/1471-2318-14-143
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发表时间：
2014-12-20
期刊：
影响因子：
4.1
通讯作者：
Masud T
中科院分区：
文献类型：
--
作者：
Thomsen K;Ryg J;Hermann AP;Matzen L;Masud T
本研究的目的是调查应用英国国家骨质疏松症学会（UK-NOS）分诊方法，使用跟骨定量超声（QUS），指骨x线吸收仪（RA），或两种方法结合，用于识别骨质疏松症女性，是否会减少老年女性中需要进一步评估双能x线吸收仪（DXA）的百分比。我们评估了286名患有髋关节和脊柱DXA的女性（Hologic Discovery），其中221人采用跟骨QUS（跟腱月）评估，245人采用指骨RA （Aleris Metriscan）评估，202人采用三种方法同时评估。对QUS、RA以及两种方法联合预测骨质疏松症（由中央DXA定义）的受试者操作特征（ROC）曲线进行分析。我们确定了不同敏感性和特异性值的截止点，并采用了UK-NOS推荐的分诊方法。计算不需要DXA进一步检查的妇女的百分比。年龄中位数为80岁（四分位数间距[IQR]）[75-85]，范围65-98。66.8%的人报告在过去12个月内至少有一次下跌。骨质疏松症患病率为44.4%。QUS组roc曲线下面积（AUC）(95%置信区间（CI）为0.808 (0.748 ~ 0.867)，RA组为0.800 (0.738 ~ 0.863)，RA和QUS联合组为0.848（0.796 ~ 0.900）。在90%的确定性水平上，UK-NOS分诊方法将使QUS患者需要进一步评估DXA的女性比例减少60%，RA患者减少43%。QUS和RA的假阴性和假阳性率分别为4% ~ 5%。对于采用90%确定性水平的联合方法，节省的dxa比例为22%，假阴性率为0%，假阳性率为0.5%。使用85%确定性水平的联合方法，节省的dxa比例增加到41%，但假阴性和假阳性值仍然很低（分别为0.5%和0.5%）。在两步分诊方法中，跟骨QUS和指骨RA表现良好，减少了需要中央DXA评估的妇女人数。结合RA和QUS减少了错误分类，同时仍然减少了对DXAs的需求。
The objective of this study was to investigate if application of United Kingdom National Osteoporosis Society (UK-NOS) triage approach, using calcaneal quantitative ultrasound (QUS), phalangeal radiographic absorptiometry (RA), or both methods in combination, for identification of women with osteoporosis, would reduce the percentage of women who need further assessment with Dual Energy X-ray Absorptiometry (DXA) among older women with a high prevalence of falls. We assessed 286 women with DXA of hip and spine (Hologic Discovery) of whom 221 were assessed with calcaneal QUS (Achilles Lunar), 245 were assessed with phalangeal RA (Aleris Metriscan), and 202 were assessed with all three methods. Receiver operator characteristics (ROC) curve for QUS, RA, and both methods in combination predicting osteoporosis defined by central DXA were performed. We identified cutoffs at different sensitivity and specificity values and applied the triage approach recommended by UK-NOS. The percentage of women who would not need further examination with DXA was calculated. Median age was 80 years (interquartile range [IQR]) [75–85], range 65–98. 66.8% reported at least one fall within the last 12 months. Prevalence of osteoporosis was 44.4%. Area under the ROC-curve (AUC) (95% confidence interval (CI)) was 0.808 (0.748-0.867) for QUS, 0.800 (0.738-0.863) for RA, and 0.848 (0.796-0.900) for RA and QUS in combination. At 90% certainty levels, UK-NOS triage approach would reduce the percentage of women who need further assessment with DXA by 60% for QUS, and 43% for RA. The false negative and false positive rates ranged from 4% to 5% for QUS and RA respectively. For the combined approach using 90% certainty level the proportion of DXAs saved was 22%, the false negative rate was 0% and false positive rate was 0.5%. Using 85% certainty level for the combined approach the proportion of DXAs saved increased to 41%, but false negative and false positive values remained low (0.5%, and 0.5% respectively). In a two-step, triage approach calcaneal QUS and phalangeal RA perform well, reducing the number of women who would need assessment with central DXA. Combining RA and QUS reduces misclassifications whilst still reducing the need for DXAs.
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DOI：
10.1109/tuffc.2008.829
发表时间：
2008-07-01
影响因子：
3.6
作者：
Hans, Didier;Krieg, Marc-Antoine
通讯作者：
Krieg, Marc-Antoine
影响因子：
6.7
作者：
Masud, T;Morris, RO
通讯作者：
Morris, RO
影响因子：
4.2
作者：
Harrison, Elizabeth J.;Adams, Judith E.
通讯作者：
Adams, Judith E.
影响因子：
168.9
作者：
DargentMolina, P;Favier, F;Breart, G
通讯作者：
Breart, G
影响因子：
4.1
作者：
Edwards, M. H.;Jameson, K.;Denison, H.;Harvey, N. C.;Sayer, A. Aihie;Dennison, E. M.;Cooper, C.
通讯作者：
Cooper, C.