Comparison of a simple clinical risk index and quantitative bone ultrasound for identifying XXXX at increased risk of @entity170 .

@entity1 @entity79 @entity170 @entity174
@entity170 is a growing problem in Asia, and early identification of at risk subjects for preventive measures is likely the most cost-effective method for managing this disease in developing countries. @entity1 with low @entity79 ( @entity79 ) have a high risk of future @entity174 . However, access to @entity79 measurements is limited in many areas of Asia, and inexpensive methods of targeting high-risk @entity1 for @entity79 measurements would be valuable. We compared two methods, a simple clinical risk assessment tool, the @entity170 Self-assessment Tool for Asians (OSTA), and quantitative bone ultrasound (QUS) in identifying subjects with low @entity79 by DXA in 722 southern Chinese postmenopausal @entity1 recruited from the community in Hong Kong. Using the published cutoff value of -1 (versus 0 or higher) for OSTA to identify subjects with femoral neck @entity79 T-score < or =-2.5, basing on our local population peak young mean value, the sensitivity and specificity was 88% and 54% respectively. The optimal cutoff T-score of -2.35 for QUS yielded sensitivity and specificity values of 81% and 65%, respectively. The AUC for QUS was 0.78, which was not significantly different from that of 0.80 for OSTA. Both OSTA and QUS correlated significantly with @entity79 at the femoral neck (0.62 and 0.36, respectively, P both <0.001). When these cut-off values were used to identify subjects with either lumbar spine or femoral neck @entity79 T-score < or =-2.5, the sensitivity and specificity was 79% and 60%, respectively, for OSTA, and 69% and 70%, respectively, for QUS. Combining QUS with OSTA improved the sensitivity to 91%, but the specificity was reduced to 44%. We conclude that the simple clinical risk assessment tool OSTA is a free and effective method for identifying subjects at increased risk of @entity170 , and its use could facilitate the appropriate and more cost-effective use of bone densitometry in developing countries.
