Performance of the Primary Osteoporosis Screening Tool (POST) in osteoporosis screening: a cross-sectional study in China.

Abstract

Objectives: This study aimed to evaluate the efficacy of the Primary Osteoporosis Screening Tool (POST) in identifying osteoporosis among Chinese adults aged 50 years and older.

Methods: This retrospective cross-sectional study consecutively included patients from the University-Town Hospital of Chongqing Medical University. Osteoporosis was defined based on the T-scores of femoral neck bone mineral density (BMD) or lumbar spine BMD by dual-energy X-ray absorptiometry examinations. The POST scores were computed according to the subject information on age, sex, and weight. In addition, the performance of the POST was assessed and compared with the Osteoporosis Self-assessment Tool for Asians (OSTA) by area under the receiver operating characteristic curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI).

Results: A total of 2861 patients were included in the final analysis, of whom 78.43% were women, with a mean age of 65.67 ± 9.81 years. The POST exhibited superior performance compared to OSTA in osteoporosis screening, as evidenced by a higher area under curve, enhanced NRI/IDI metrics, and remarkable sensitivity. Subgroup analysis further highlighted the superior efficacy of POST in individuals aged 65 years and older. Additionally, sensitivity analysis confirmed that the POST maintained robust performance in identifying individuals with osteoporosis, even after the exclusion of underweight patients.

Conclusions: The POST has been shown to be an effective instrument for osteoporosis screening among Chinese adults. Nonetheless, this study has limitations including its single-center retrospective design and imbalanced gender distribution, which may affect generalizability.