Table 4.
Test Performance in Predicting OP at Defined Low-Risk Thresholds
| Test Performance | Ten-Year Fracture Risk as Predicted by FRAX without BMD | OSTA, % | BMI, % | |
|---|---|---|---|---|
| HF, % | MOF, % | |||
| Lumbar spine BMD≤-2.5 | ||||
| Sensitivity | 72.6 | 71.4 | 67.5 | 55.7 |
| Specificity | 65.1 | 64.7 | 69.8 | 70.4 |
| Positive predictive value | 34.1 | 33.4 | 35.7 | 31.8 |
| Negative predictive value | 90.5 | 90.1 | 89.6 | 86.5 |
| Tests saveda | 42.4 | 42.5 | 37.6 | 34.8 |
| OP missedb | 5.5 | 5.7 | 6.5 | 8.8 |
| Cut-off value | 1.0 | 4.6 | −1.0 | 23.2 |
| Femoral neck BMD≤-2.5 | ||||
| Sensitivity | 84.1 | 80.7 | 78.5 | 53.3 |
| Specificity | 66.3 | 65.5 | 70.9 | 69.0 |
| Positive predictive value | 34.1 | 32.6 | 35.8 | 26.3 |
| Negative predictive value | 95.3 | 94.2 | 94.1 | 87.7 |
| Tests saved | 42.4 | 42.5 | 37.6 | 34.8 |
| OP missed | 2.7 | 3.3 | 3.7 | 8.0 |
| Cut-off value | 1.3 | 4.4 | −1.0 | 22.6 |
| Total hip BMD≤-2.5 | ||||
| Sensitivity | 89.8 | 86.8 | 85.6 | 61.7 |
| Specificity | 61.8 | 61.4 | 66.6 | 67.5 |
| Positive predictive value | 17.2 | 16.6 | 18.5 | 14.4 |
| Negative predictive value | 98.6 | 98.1 | 98.1 | 95.2 |
| Tests saved | 42.4 | 42.5 | 37.6 | 34.8 |
| OP missed | 0.8 | 1.1 | 1.2 | 3.1 |
| Cut-off value | 1.9 | 6.8 | −2.0 | 22.7 |
| Worst hip BMD≤-2.5 | ||||
| Sensitivity | 84.1 | 81.1 | 78.4 | 52.6 |
| Specificity | 66.8 | 66.0 | 71.4 | 69.1 |
| Positive predictive value | 35.8 | 34.5 | 37.6 | 27.2 |
| Negative predictive value | 95.0 | 94.1 | 93.8 | 86.9 |
| Tests saved | 42.4 | 42.5 | 37.6 | 34.8 |
| OP missed | 2.9 | 3.4 | 3.9 | 8.6 |
| Cut-off value | 1.3 | 4.5 | −1.0 | 22.6 |
| Worst any set BMD≤-2.5 | ||||
| Sensitivity | 74.8 | 73.1 | 69.6 | 52.0 |
| Specificity | 70.4 | 69.6 | 75.1 | 71.9 |
| Positive predictive value | 50.1 | 48.8 | 52.5 | 42.3 |
| Negative predictive value | 87.6 | 86.7 | 86.2 | 79.1 |
| Tests saved | 42.4 | 42.5 | 37.6 | 34.8 |
| OP missed | 7.2 | 7.6 | 8.6 | 13.6 |
| Cut-off value | 1.0 | 4.6 | −1.0 | 22.7 |
Notes: aPer 100 participants who were candidates for screening BMD and primary prevention. bA percentage of participants who had OP according to BMD testing with negative results of predicting tool.
Abbreviations: BMD, body mineral density; BMI, body mass index; FRAX, Fracture Risk Assessment Tool; HF, hip fractures; MOF, major osteoporotic fractures; OSTA, Osteoporosis Self-Assessment Tool for Asians.