Performance of the osteoporosis self-assessment screening tool for osteoporosis in American men

Objective: To determine whether the Osteoporosis Self assessment Tool (091) can predict central bone mineral density in men, as defined by,dual energy x-ray absorptiometry (DXA). Patients and Methods: We applied the OST. index to men in pulmonary (evaluated January-May 2001) and rheumatology (evaluated November 2001-March 2002) clinics at a veterans hospital. The calculated OST risk index is based on weight and age. Results: In 181 men, we arbitrarily defined osteoporosis as a DXA T score of-2.5 or less in the spine, total hip, or femoral neck. The mean age and weight of the men were 643 years and 912 kg; 15.6% had osteoporosis by DXA. The OST index ranged from -5 to 19, from which we categorized risk as follows: low, 4 or greater; moderate, -1 to 3; and high, -2 or less. Only 2.0% of men with a low-risk OST index had osteoporosis, whereas 27.0% with a moderate risk and 72.7% with a high risk had osteoporosis. Using an OST cutoff score of 3, we predicted osteoporosis with a sensitivity of 93% and a specificity of 66% When patients were studied by age in decades, race, or current glucocorticoid use, the predictive value of the COST was maintained. Conclusion: The OST is an easy method to predict osteoporosis by DXA.