SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2015
Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Pooled it
- A systematic review of intervention thresholds based on FRAX : A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation.Archives of osteoporosis · 2016Pooled it
- Revisiting the Osteoporosis Self-Assessment Tool (OST): evidence from a multi-cohort study in Asia supporting age-dependent thresholds.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Predicting Hip Osteoporosis with Routine Demographic and Biochemical Data: The Shao HipOsteoRisk Model.Clinical interventions in aging · 2026Observational
- Inequities Across the Spectrum of Osteoporosis Care and Post-Fracture Management in Men.Current osteoporosis reports · 2025Review
- Interpretable machine learning model for low bone density screening in older adults using demographic and anthropometric data: findings from 2005 to 2020 NHANES.BMC medical informatics and decision making · 2025Article
- Performance of the Primary Osteoporosis Screening Tool (POST) in osteoporosis screening: a cross-sectional study in China.European journal of medical research · 2025Article
- Bone Health, Fragility Fractures, and the Hand Surgeon.Journal of hand surgery global online · 2025Review
- Comparing machine learning models for osteoporosis prediction in Tibetan middle aged and elderly women.Scientific reports · 2025Article
- Osteoporosis risk and its association with all-cause and cause-specific mortality among the elderly: a 16-year nationwide cohort study.BMC geriatrics · 2025Article
- Article
- Comparative Evaluation of Osteoporosis Clinical Risk Assessment Tools in Postmenopausal Women Aged 50-64.Journal of musculoskeletal & neuronal interactions · 2024Article
- Osteoporosis in men-East and West: Can the twain meet? A perspective from Asia.Osteoporosis and sarcopenia · 2024Review
- Associations between gut microbiota and osteoporosis or osteopenia in a cohort of Chinese Han youth.Scientific reports · 2024Article
- Clinical Validation of a Deep Learning-Based Software for Lumbar Bone Mineral Density and T-Score Prediction from Chest X-ray Images.Diagnostics (Basel, Switzerland) · 2024Article
- Insights and implications of sexual dimorphism in osteoporosis.Bone research · 2024Review
- Osteoporosis Prediction Using Machine-Learned Optical Bone Densitometry Data.Annals of biomedical engineering · 2024Article
- A novel primary osteoporosis screening tool (POST) for adults aged 50 years and over.Endocrine · 2023Article
- Klotho reduces the risk of osteoporosis in postmenopausal women: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES).BMC endocrine disorders · 2023Article
- Development and Validation of a New Clinical Diagnostic Screening Model for Osteoporosis in Postmenopausal Women.Journal of bone metabolism · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
unlabelledWe performed a systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for DXA-determined osteoporosis or low bone density. Commonly evaluated risk instruments showed high sensitivity approaching or exceeding 90% at particular thresholds within various populations but low specificity at thresholds required for high sensitivity. Simpler instruments, such as OST, generally performed as well as or better than more complex instruments.
introductionThe purpose of the study is to systematically review the performance of clinical risk assessment instruments for screening for dual-energy X-ray absorptiometry (DXA)-determined osteoporosis or low bone density.
methodsSystematic review and meta-analysis were performed. Multiple literature sources were searched, and data extracted and analyzed from included references.
resultsOne hundred eight references met inclusion criteria. Studies assessed many instruments in 34 countries, most commonly the Osteoporosis Self-Assessment Tool (OST), the Simple Calculated Osteoporosis Risk Estimation (SCORE) instrument, the Osteoporosis Self-Assessment Tool for Asians (OSTA), the Osteoporosis Risk Assessment Instrument (ORAI), and body weight criteria. Meta-analyses of studies evaluating OST using a cutoff threshold of <1 to identify US postmenopausal women with osteoporosis at the femoral neck provided summary sensitivity and specificity estimates of 89% (95%CI 82-96%) and 41% (95%CI 23-59%), respectively. Meta-analyses of studies evaluating OST using a cutoff threshold of 3 to identify US men with osteoporosis at the femoral neck, total hip, or lumbar spine provided summary sensitivity and specificity estimates of 88% (95%CI 79-97%) and 55% (95%CI 42-68%), respectively. Frequently evaluated instruments each had thresholds and populations for which sensitivity for osteoporosis or low bone mass detection approached or exceeded 90% but always with a trade-off of relatively low specificity.
conclusionsCommonly evaluated clinical risk assessment instruments each showed high sensitivity approaching or exceeding 90% for identifying individuals with DXA-determined osteoporosis or low BMD at certain thresholds in different populations but low specificity at thresholds required for high sensitivity. Simpler instruments, such as OST, generally performed as well as or better than more complex instruments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.