在低资源环境中开发一种具有成本效益的骨质疏松症风险评分系统：以社区为基础的方法

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-04-19 DOI:10.1016/j.jcot.2025.103018

Muhammad Muzzammil , Muhammad Owais Minhas , Amna Jamil

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引用次数: 0

摘要

背景：骨质疏松性骨折构成了重大的公共卫生负担，特别是在资源有限、无法获得DXA扫描等诊断工具的地区。本研究旨在开发和验证一个简单的、基于社区的骨质疏松症风险评分系统，该系统结合了人口统计学、临床和放射学参数，以识别早期干预的高危人群。方法在巴基斯坦卡拉奇进行了一项横断面研究，涉及750名年龄在40岁及以上的参与者。采用结构化问卷收集人口统计学特征、临床危险因素和生活习惯的数据。x线评估发现椎体压缩性骨折、广泛性骨质减少和小梁骨丢失。参与者被分为四个风险类别：低、中、高和非常高的风险。采用logistic回归和受试者工作特征（ROC）曲线分析评价评分系统的预测效度。结果开发的工具将参与者分为低（38%）、中（32%）、高（20%）和非常高（10%）风险组。骨折发生率从低危组的11.29%到高危组的28.23%不等。该评分系统具有较强的预测准确性，灵敏度为83%，特异性为75%，曲线下面积（AUC）为0.82。骨折的优势比随着风险类别的增加而逐渐增加，证实了模型的有效性。结论Muzzammil骨质疏松风险评分系统是低资源环境下早期识别高危人群的一种经济实用的工具。它的实施有助于制定有针对性的预防策略，减少骨质疏松性骨折的发生率，改善公共卫生结果。建议在不同人群中进一步验证以优化其效用。

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Development of a cost-effective osteoporosis risk scoring system for early detection in low-resource settings: A community-based approach

Background

Osteoporotic fractures pose a significant public health burden, particularly in resource-constrained settings where diagnostic tools like DXA scans are unavailable. This study aimed to develop and validate a simple, community-based osteoporosis risk scoring system that incorporates demographic, clinical, and radiographic parameters to identify high-risk individuals for early intervention.

Methods

A cross-sectional study was conducted in Karachi, Pakistan, involving 750 participants aged 40 years and above. Data on demographic characteristics, clinical risk factors, and lifestyle habits were collected using a structured questionnaire. Radiographic assessments identified vertebral compression fractures, generalized osteopenia, and trabecular bone loss. Participants were stratified into four risk categories: low, moderate, high, and very high risk. The predictive validity of the scoring system was evaluated using logistic regression and receiver operating characteristic (ROC) curve analysis.

Results

The developed tool classified participants into low (38 %), moderate (32 %), high (20 %), and very high (10 %) risk groups. Fracture incidence ranged from 11.29 % in the low-risk group to 28.23 % in the very high-risk group. The scoring system demonstrated strong predictive accuracy, with a sensitivity of 83 %, specificity of 75 %, and an area under the curve (AUC) of 0.82. Odds ratios for fractures progressively increased with higher risk categories, confirming the model's validity.

Conclusion

This Muzzammil's osteoporosis risk scoring system is a cost-effective and practical tool for early identification of high-risk individuals in low-resource settings. Its implementation could aid in targeted prevention strategies, reducing osteoporotic fracture incidence and improving public health outcomes. Further validation in diverse populations is recommended to optimize its utility.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.