The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above (original) (raw)
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Therapeutics and clinical risk management, 2017
Calcaneal quantitative ultrasound (QUS) is a useful tool in osteoporosis screening. However, QUS device may not be available at all primary health care settings. Osteoporosis self-assessment tool for Asians (OSTA) is a simple algorithm for osteoporosis screening that does not require any sophisticated instruments. This study explored the possibility of replacing QUS with OSTA by determining their agreement in identifying individuals at risk of osteoporosis. A cross-sectional study was conducted to recruit Malaysian men and women aged ≥50 years. Their bone health status was measured using a calcaneal QUS device and OSTA. The association between OSTA and QUS was determined using Spearman's correlation and their agreement was assessed using Cohen Kappa and receiver-operating curve. All QUS indices correlated significantly with OSTA (p<0.05). The agreement between QUS and OSTA was minimal but statistically significant (p<0.05). The performance of OSTA in identifying subjects a...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2007
To examine the diagnostic performance of clinical risk indices combined with quantitative ultrasound calcaneus measurement (QUS) for identifying osteoporosis in Thai postmenopausal women. The present study was designed as a cross-sectional investigation in 300 Thai women, aged between 38 and 85 years (mean age: 58). Femoral neck bone mineral density (BMD) was measured by DXA (Hologic QDR-4500; Hologic, Bedford, MA, USA). A BMD T-scores < or = -2.5 was defined as "osteoporosis"; otherwise, "non-osteoporosis". QUS was measured by Achilles+ (GE Lunar, Madison, WI, USA) and converted to T-score. The OSTA and KKOS score was calculated for each woman using her age and weight Women with OSTA/KKOS scores < or = -1 and > -1 were classified as "high risk" and "low risk", respectively. Using DXA as the gold standard, the sensitivity of QUS to identify osteoporosis was lower than the sensitivity of OSTA/KKOS (60 vs. 71/74%) but the specificity an...
Osteoporosis and Sarcopenia, 2021
Objectives: Calcaneal quantitative ultrasound measurement (QUS) has been considered an alternative to dual-energy X-ray absorptiometry (DXA) based bone mineral density (BMD) for assessing bone health. This study sought to examine the utility of QUS as an osteoporosis screening tool by evaluating the correlation between QUS and DXA. Methods: The study was a part of the Vietnam Osteoporosis Study that involved 1270 women and 773 men aged 18 years and older. BMD at the femoral neck, total hip and lumbar spine was measured using DXA. Osteoporosis was diagnosed based on the femoral neck T-score using World Health Organization criteria. Broadband ultrasound attenuation (BUA) at the calcaneus was measured by QUS. The concordance between BUA and BMD was analyzed by the linear regression model. Results: In all individuals, BUA modestly correlated with femoral neck BMD (r ¼ 0.35; P < 0.0001) and lumbar spine BMD (r ¼ 0.34; P < 0.0001) in both men and women. In individuals aged 50 years and older, approximately 16% (n ¼ 92/575) of women and 3.2% (n ¼ 10/314) of men were diagnosed to have osteoporosis. Only 0.9% (n ¼ 5/575) women and 1.0% (n ¼ 3/314) men were classified as "Low BUA". The kappa coefficient of concordance between BMD and BUA classification was 0.09 (95% CI, 0.04 to 0.15) for women and 0.12 (95% CI, 0.03 to 0.22) for men. Conclusions: In this population-based study, QUS BUA modestly correlated with DXA BMD, suggesting that BUA is not a reliable method for screening of osteoporosis.
Journal of Clinical Densitometry, 2003
Screening of osteoporosis by quantitative ultrasound (QUS) has become widely available in Europe, but no clear strategies for its clinical use have been established. The aim of this study was to validate the use of QUS in a cross-sectional study carried out in three primary care centers. Measurements of calcaneal QUS and bone mineral density (BMD) at proximal femur were obtained by dual-energy X-ray absorptiometry (DXA). Osteoporosis was diagnosed by DXA T-score ≤ -2.5 at the femoral neck. Sensitivity, specificity, kappa index, and receives operator characteristics (ROC) curve QUS values were calculated with respect to the standard reference. Both positive and negative likelihood ratios (LR) were used to calculate the optimum cut-off levels. Two hundred and sixty-seven women aged 65 or older were included. Fifty-five percent had osteoporotic femoral neck BMD values (T-score ≤ -2.5). The same threshold for QUS yielded a lower prevalence of osteoporosis (10%). Women with BMD diagnosis of osteoporosis were older and showed lower age-adjusted values for all QUS parameters (p < 0.001). Area under the curve (AUC) ranged from 0.662-0.678 for the different QUS parameters; correlation and concordance of all parameters with femoral neck BMD were statistically significant (p < 0.001). Cut-off values calculated from the AUC yielded 61.1% sensitivity and 65.3% specificity for the best QUS parameter (i.e., Estimated Heel T-score ≤ -1.55). Estimated Heel T-score values of +0.05 or above ruled out osteoporosis (LR 0.18), whereas those -2.50 or below supported the diagnosis (LR 5.98). The application of these cutoff points allowed classification of 22.1% of cases. In conclusion, in postmenopausal women, QUS screening conclusively confirms or rules out osteoporosis in approximately one-fifth of cases, thereby avoiding the need for a DXA measurement.
Accuracy of quantitative ultrasound parameters in the diagnosis of osteoporosis
Open Medicine, 2010
Quantitative ultrasound (QUS) is of increasing interest for evaluation of osteoporosis because, compared with dual-energy X-ray absorptiometry (DXA), it is portable, less expensive, and radiation-free. The aim of our study was to determine the sensitivity, specificity, and cut-off values of quantitative ultrasound parameters in identifying patients with osteoporosis compared to the World Health Organization (WHO) standard definition. We performed a cross-sectional investigational study of 73 subjects, and determined total hip and lumbar spine T-scores by dual-energy X-ray absorptiometry (DXA) (Prodigy Advance Lunar-GE). The QUS parameters (broadband ultrasound attenuation [BUA], speed of sound, bone mineral density, the stiffness index, and QUS T-score) were determined with Sahara Hologic equipment. The AUC was 0.81 (95% CI 0.67–0.95, p<0.05) for speed of sound (SOS) and 0.76 (95% CI 0.62–0.90, p<0.05) for BUA for the patients with DXA T-scores ≥ −1 DS; the cut-off values were...
The role of quantitative ultrasound in predicting osteoporosis defined by dual X-ray absorptiometry
Rheumatology International, 2001
The aim of this study was to establish whether quantitative ultrasound (QUS) parameters could identify patients classi®ed as osteoporotic and osteopenic on the basis of dual energy X-ray absorptiometry (DEXA). One hundred and twenty-three patients (39 male, 84 female) with osteoporosis and suspected of having osteoporosis were included in this study. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured and bone mineral densities (BMD) of the lumbar spine and left hip was measured by DEXA. Subjects were classi®ed into three groups (normal, osteopenic and osteoporotic) on the basis of BMD T-scores measured by DEXA. QUS parameters of the osteoporotic group were signi®cantly lower than those of osteopenic and normal groups; there was no dierence in QUS parameters between the normal and osteopenic groups. Correlations of both right and left SOS and BUA with the spine and femoral neck BMD were moderate (r 0.343±0.539, P < 0.001). There was also reasonable correlation between DEXA and QUS T-scores (r 0.364±0.510, P < 0.001). QUS had a sensitivity of 21% and a speci®city of 95% for diagnosing osteoporosis. We concluded that, although DEXA and QUS parameters were signi®cantly correlated, QUS parameters can not predict osteopenia as de®ned by DEXA, and sensitivities and speci®cities of QUS parameters were not suciently high for QUS to be used as an alternative to DEXA.
Prescreening for Osteoporosis With Quantitative Ultrasound in Postmenopausal White Women
Journal of Ultrasound in Medicine
Background: Calcaneal quantitative ultrasound (QUS) is a readily accessible and radiation-free alternative to DXA for assessing BMD. Results obtained from QUS measurement cannot directly be compared to DXA, since these two techniques capture different bone-specific parameters. In order to identify individuals who are likely to have osteoporosis by DXA, device-specific thresholds have to be defined for QUS. Objective: This cross-sectional study evaluated the accuracy of QUS to identify postmenopausal women with osteoporosis defined as a T-score of ≤-2.5 SD by DXA, and to calculate devicespecific cutoff values for the QUS device investigated. Methods: We assessed BMD at the lumbar spine, bilateral femoral neck and total hip sites with DXA, and QUS parameters of the right and left calcaneus in a cohort of 245 postmenopausal treatment-naive women between the age of 40 and 82. Correlation coefficients of BMD and QUS parameters were calculated. Receiver operating characteristic (ROC) curves were generated and areas under the curves (AUC) evaluated. Cutoff values for QUS were defined. Results: Calcaneal QUS' has the ability to identify postmenopausal women with a T-score ≤-2.5 at the right hip (AUC = 0.887) and left femoral neck (AUC = 0.824). Cutoff values for the QUS T-score of the right (-1.455) and left (-1.480) calcaneus were defined for screening purposes. Conclusion: This study provides insights into the comparative performance of QUS with DXA. Considering the diagnostic accuracy of this device in comparison with DXA it can be recommended as a pre-screening tool to reduce the number of DXA screenings. Capsule summary Quantitative Ultrasound as valuable alternative for osteoporosis prescreening. Quantitative Ultrasound cutoff values for "Pegasus". Quantitative Ultrasound is low cost and readily accessible compared to DXA.
Calcified Tissue International, 2002
The study assessed the precision, sensitivity, and speci®city of a recently developed peripheral dualenergy X-ray absorptiometry (DXA) scanner, applied to the calcaneus, in the identi®cation of individuals with osteoporosis at axial sites by DXA. Two hundred and two women, aged 55.2 l3.7 years (mean SD), participated in the study. The precisions (coecient of variation) of measurements in vitro (0.48%) and in vivo (1.40%) were very good. The in vivo precision was independent of the operator, foot size, foot width, weight, height, and body mass index. Calcaneus BMD correlated moderately (r = 0.494±0.690, P < 0.001) with axial BMD measurements by DXA. Using the World Health Organization (WHO) criterion for de®ning osteoporosis (T score £ )2.5) the speci®city of the calcaneus to identify patients with osteoporosis at total hip, femoral neck, spine, or any of these axial sites was excellent (97.0%, 97.0%, 96.5%, and 97.1%, respectively); however, the sensitivity was poor (58.8%, 36.4%, 21.8%, and 20.3%, respectively). Therefore, the WHO criterion is not appropriate for DXA calcaneus. Based on femoral neck BMD for detection of osteoporosis, a more appropriate calcaneus T score threshold would be )1.4 by analyses of receiver-operator characteristic curves; this might serve to select those patients who might appropriately be referred for axial DXA.
Quantitative Ultrasound and Bone Health in Elderly People, a Systematic Review
Biomedicines
Reduced bone mineral density (BMD), osteoporosis, and their associated fractures are one of the main musculoskeletal disorders of the elderly. Quickness in diagnosis could prevent associated complications in these people. This study aimed to perform a systematic review (SR) to analyze and synthesize current research on whether a calcaneal quantitative ultrasound (QUS) can estimate BMD and predict fracture risk in elderly people compared to dual-energy x-ray absorptiometry (DXA), following the PRISMA guidelines. A search was conducted in the main open-access health science databases: PubMed and Web of Science (WOS). DXA is the gold standard for the diagnosis of osteoporosis. Despite controversial results, it can be concluded that the calcaneal QUS tool may be a promising method to evaluate BMD in elderly people, facilitating its prevention and diagnosis. However, further studies are needed to validate the use of calcaneal QUS.