/publications/issue/2005/2005-06/2005-06-9610

Rules Do Not Spot Bone Thinning

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Physicians may want to rethink using clinical prediction rules to identify which women will develop osteoporosis. On the other hand, the rules are useful at recognizing women who are not likely to have the condition and most likely do not require bone density scans. The findings, reported in the Archives of Internal Medicine (March 14, 2005), are based on a study of 202 women who were assessed with 3 clinical prediction rules.

The rules work by assigning points for known osteoporosis risk factors and totaling them together. The higher the score, the greater is the chance that the disease will develop. The current study compared the scores with actual bone test results. The scores detected 98% of the women who were at risk for osteoporosis. The rules, however, also predicted osteoporosis in a significant number of women who were unlikely to develop the disease based on their bone test results.

The researchers concluded, "Our results suggest that these clinical prediction rules do not perform well as a general screening method to identify postmenopausal women who are more likely to have osteoporosis. However, [the rules] may be useful in identifying women who need not undergo testing, especially younger postmenopausal women."