Article Figures & Data
Figures
- Figure 1
Comparison of the areas under the receiver operating characteristic curves of the MORES and FRAX for predicting osteoporosis in men based on T scores from the hip.
AUC = area under the curve; FRAX = a fracture risk assessment tool; MORES = Male Osteoporosis Risk Estimation Score.
Tables
Variables Value FRAX Age, mean (SD), y 64.2 (9.7) Race/ethnicity Non-Hispanic white, No. (%) 1,326 (88.5) African-American, No. (%) 128 (8.5) Mexican-American, No. (%) 44 (2.9) Height, mean (SD), cm 174.6(6.8 Weight, mean (SD), kg 82.9 (14.6) BMI, mean (SD) 27.2 (4.3) History of low-impact fracture, % 11 (0.7) Parental history of hip fracture, %a 117 (7.8) Current smoker, % 418 (27.9) Use of glucocorticoids, %b 25 (1.6) History of rheumatoid arthritis, % 57 (3.8) Secondary causes of osteoporosis, %c 7 (0.5) Current alcohol use: ³3 drinks per day, % 73 (4.9) MORES Age, y ≤55, % 337 (22.5) 56–74, % 907 (60.6) ≥75, % 254 (17.0) Weight, kg ≤70, % 268 (17.9) 71–80, % 386 (25.8) >80, % 843 (56.3) History of COPD, % 150 (10.0) Bone mineral densityd Osteoporosis, % 67 (4.5) Osteopenia, % 501 (33.4) Normal, % 930 (62.1) BMI = body mass index; COPD = chronic obstructive pulmonary disease; FRAX = a fracture risk assessment tool; MORES = Male Osteoporosis Risk Estimation Score; NHANES III = National Health and Nutrition Examination Survey III.
↵a NHANES III included only maternal history of fracture.
↵b NHANES III included only current use of glucocorticoids.
↵c NHANES III included data to support only type 1 diabetes, hypogonadism, and hyperthyroidism.
↵d Classified based on bone mineral density of total hip and/or femoral neck.
- Table 3
A Comparison of the Operating Characteristics of the FRAX and MORES for Predicting Osteoporosis in Men Based on T Scores From the Hip
Parameter FRAX MORES Sensitivity (95% CI) 0.39 (0.27–0.51) 0.96 (0.87–0.99) Specificity (95% CI) 0.89 (0.87–0.91) 0.61 (0.58–0.63) Predictive value positive (95% CI) 0.14 (0.09–0.20) 0.10 (0.08–0.13) Predictive value negative (95% CI) 0.97 (0.96–0.98) 1.00 (0.99–1.00) Area under curve (95% CI) 0.79 (0.74–0.84) 0.87 (0.84–0.91) FRAX = a fracture risk assessment tool; MORES = Male Osteoporosis Risk Estimation Score.
The Article in Brief
A Comparison of the Male Osteoporosis Risk Estimation Score (MORES) and the FRAX in Identifying Men at Risk for Osteoporosis
Alvah R. Cass , and colleagues
Background This study compares the Male Osteoporosis Risk Estimation Score (MORES) and the Fracture Risk Assessment Tool (FRAX) in screening men for osteoporosis.
What This Study Found Compared to the MORES, the FRAX under-performs as a screening strategy for osteoporosis using the threshold score suggested by the US Preventive Services Task Force. Among men aged 50 years and older, based on the MORES, 42 percent of men in the sample would be referred for a follow-up dual-energy x-ray absorptiometry (DXA) scan, of whom 10 percent had osteoporosis. In comparison, based on the FRAX, 12 percent of men would be referred for DXA, of whom 14 percent had osteoporosis. Agreement between the two screening tools was poor. When the MORES and FRAX were integrated, they identified 82 percent of men who were candidates for treatment.
Implications
- An integrated approach, which uses the MORES to identify men who should undergo a diagnostic DXA scan and the FRAX to guide treatment decisions, may be optimal.
