Validation of a Self‐Assessment Tool for Osteoporosis and Vertebral Fracture Primary Screening in Elderly Men

OBJECTIVE: The early identification of osteoporosis and vertebral fractures (VFs) is vital for improving the quality of life in elderly men. This study aimed to validate the effectiveness of a self-assessment tool for osteoporosis and VFs primary screening in the elderly men. METHODS: This real-world study analyzed data from two sources: an electronic health record (EHR) database comprising 7187 subjects and a community database including 6313 subjects. Restricted cubic spline curves were utilized to analyze the relationship between the osteoporosis self-assessment tool for Asians (OSTA) index and the prevalence of osteoporosis, overall VFs, and moderate to severe VFs. Diagnostic performance was assessed by calculating sensitivity, specificity, and area under the receiver operating characteristic curve (AUC), and optimal cutoff values were determined for different age groups. RESULTS: With a cutoff value of -1, the OSTA index demonstrated good diagnostic performance for identifying osteoporosis, achieving an AUC of 0.712 (p < 0.001), with sensitivity and specificity of 81.6% and 78.1%, respectively. The screening performance was notably higher among individuals aged 70-79 and those over 80 years, with AUCs of 0.79 and 0.81, respectively, and sensitivities exceeding 90%. For moderate to severe VFs, the OSTA index demonstrated a sensitivity of 86.6%, a specificity of 53.1%, and an AUC of 0.628. CONCLUSIONS: This large-scale real-world study supports the utility of the OSTA index as a valid tool for the primary screening of osteoporosis and VFs in the elderly men.