ArticleJAMA network open2025
Identifying Younger Postmenopausal Women With Osteoporosis Using USPSTF-Recommended Osteoporosis Risk Assessment Tools.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- TLS-VBQ: a novel MRI-based bone quality score for opportunistic osteoporosis screening in spinal surgery candidates.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Optimal visceral adipose tissue thresholds that minimize risk for osteoporosis and/or diabetes in midlife women.Journal of the Endocrine Society · 2026Article
- Perceptions of osteoporosis risk assessment during menopause: a qualitative focus group study of patients and healthcare professionals in the UK.BMJ public health · 2026Article
- Environmental Micro-Nanoplastics and Musculoskeletal Disorders: Current Research and Insights.International journal of nanomedicine · 2026Review
- Development and validation of an interpretable machine learning model for osteoporosis prediction using routine blood tests: a retrospective cohort study.BMC medical informatics and decision making · 2025Article
- Performance of USPSTF-recommended osteoporosis risk assessment tools in identifying osteoporosis in older men: a multicentre retrospective study.Frontiers in endocrinology · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
Importance: For younger postmenopausal women, clinical guidelines recommend using osteoporosis risk prediction tools to identify candidates with low bone mineral density (BMD). However, the performance of these tools is not well quantified. Objective: To examine the performance of Osteoporosis Risk Assessment Instrument (ORAI) and Osteoporosis Index of Risk (OSIRIS), compared with Osteoporosis Self-Assessment Tool (OST), in identifying the presence of osteoporotic BMD in younger postmenopausal women. Design, Setting, and Participants: This cross-sectional study used data from the Women's Health Initiative Bone Density Substudy, which was conducted at 3 clinical centers in Tucson and Phoenix, Arizona; Pittsburgh, Pennsylvania; and Birmingham, Alabama. Participants were healthy postmenopausal women aged 50 to 64 years with BMD measurements evaluated using the 3 risk prediction tools: OSIRIS, ORAI, and OST. Risk factors and other participant characteristics were compared across osteoporosis status. Data were collected from October 1993 to December 1998 and analyzed between September 23, 2023, and April 10, 2024. Exposures: The primary exposures were OSIRIS, ORAI, and OST risk scores. Main Outcomes and Measures: Primary outcome was osteoporosis defined by BMD T score of -2.5 or lower at 1 or more of 3 anatomical locations: femoral neck, total hip, and/or lumbar spine. The tools were evaluated via area under the receiver operating characteristic curve (AUC) at published score cutoffs and at alternate cutoffs. Results: Among 6067 included participants (mean [SD] age at baseline, 57.7 [4.1] years), the prevalence of osteoporosis was 14.1% (n = 857) at any 1 of 3 anatomical sites. AUC for identifying osteoporosis at any site was 0.633 (95% CI, 0.633-0.634) for OSIRIS, 0.663 (95% CI, 0.663-0.664) for ORAI, and 0.654 (95% CI, 0.654-0.655) for OST. Conclusions and Relevance: In this cross-sectional study, 3 guideline-recommended osteoporosis risk assessment tools had fair to moderate discrimination in identifying osteoporosis defined by lowest BMD at any 1 of 3 skeletal sites. Screening is essential to reducing individual and societal burden of osteoporosis and related fractures, and this study showed a gap in identifying younger postmenopausal women using common clinical risk factors.
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