Risk Assessment Tools for Osteoporosis Screening in Postmenopausal Women: A Systematic Review

Osteoporotic fractures are common in postmenopausal women. Tools are available to estimate the risk of low bone mineral density (BMD) or fracture. This systematic review retrieved articles that evaluated osteoporosis risk assessment tools among postmenopausal women in North America. For identifying BMD T-score a parts per thousand currency signa'2.5, most studies of the Simple Calculated Osteoporosis Risk Estimation tool (SCORE) and Osteoporosis Risk Assessment Instrument (ORAI) reported sensitivity a parts per thousand yen90 %. Area under the receiver operating characteristic curve (AUC) was usually < 0.75 for SCORE and a parts per thousand yen0.75 for ORAI. Among women 50-64 years old, a Fracture Risk Assessment Tool (FRAX) threshold a parts per thousand yen9.3 % had a sensitivity of 33 % for identifying BMD T-score a parts per thousand currency signa'2.5 and 26 % for predicting major osteoporotic fracture (MOF). For predicting MOF, sensitivity was higher for SCORE and Osteoporosis Self-assessment Tool equation (OST), and higher in women a parts per thousand yen65 years old. For predicting BMD T-score a parts per thousand currency signa'2.5 in women a parts per thousand yen65 years old, the sensitivities of SCORE; ORAI; and Age, Body Size, No Estrogen (ABONE) were very high. No optimal osteoporosis risk assessment tool is available for identifying low BMD and MOF risk.