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Risk Factor MORES Points* Age (years) ≤55 0 56–74 3 ≥75 4 Weight, kg (lbs) ≤70 (≤154) 6 >70–80 kg (>154–176) 4 >80 (>176) 0 COPD 3 * Screening threshold is ≥6 points.
MORES, Male Osteoporosis Risk Estimation Score; COPD, chronic obstructive pulmonary disorder.
- Table 2.
Sample Demographics of Men 50 Years of Age and Older from the National Health and Nutrition Examination Survey, 1999 to 2004
N Adjusted % Race (n = 2944) White 1720 81.0 African-American 483 8.2 Mexican-American 573 3.6 Other 168 7.2 Age (n = 2944) Mean 62.99 95% CI, 62.53–63.44 ≤55 526 31.0 56–74 1643 52.9 ≥75 775 16.1 Weight (n = 2932) Mean 86.12 95% CI, 85.35–86.87 ≤70 kg 591 15.2 71–80 kg 762 23.5 >80 1591 61.3 Osteoporosis (any site) (n = 2944) No 2580 89.7 Yes 364 10.3 Osteoporosis (vertebral) (n = 2944) No 2818 95.7 Yes 126 4.3 COPD (n = 2943) No 2708 92.3 Yes 235 7.7 COPD, chronic obstructive pulmonary disorder.
- Table 3.
Sample Demographics of Men by Osteoporosis Prevalence by Race/Ethnicity from the National Health and Nutrition Examination Survey, 1999 to 2004
Race/Ethnicity Any Site* Vertebra White 10.04 (8.59–11.70) 4.10 (3.14–5.32) African-American 4.30 (2.62–6.97) 1.34 (0.55–3.23) Mexican-American 14.46 (11.03–18.72) 7.22 (4.66–11.03) Other 17.74 (12.59–24.41) 9.10 (4.67–16.98) Totals 10.28 (9.03–11.69) 4.34 (3.48–5.41) Data provided as % (range).
* Excludes skull.
- Table 4.
Operating Characteristics of the Male Osteoporosis Risk Estimation Score in Predicting Osteoporosis
Osteoporosis Any site L-Vertebra Sensitivity* (95% CI) Specificity* (95% CI) AUC* Sensitivity* (95% CI) Specificity* (95% CI) AUC* Overall (all men; n = 2944) 0.655 (0.582–0.721) 0.675 (0.649–0.701) 0.728 0.582 (0.460–0.694) 0.652 (0.627–0.676) 0.657 By Race/Ethnicity White (n = 1720) 0.599 (0.518–0.675) 0.694 (0.666–0.721) 0.721 0.511 (0.381–0.639) 0.672 (0.646–0.698) 0.653 African-American (n = 483) 0.787 (0.486–0.935) 0.629 (0.582–0.673) 0.781 0.763 (0.253–0.969) 0.616 (0.566–0.664) 0.786 Mexican-American (n = 573) 0.713 (0.578–0.819) 0.588 (0.528–0.645) 0.703 0.596 (0.395–0.768) 0.555 (0.499–0.610) 0.601 Other (n = 168) 0.951 (0.825–0.987) 0.551 (0.449–0.650) 0.675 0.904 (0.662–0.978) 0.499 (0.402–0.596) 0.648 * All values were adjusted for sampling and design effects using SUDAAN software.
AUC, area under the curve.
- Table 5.
Screening for Vertebral Osteoporosis in 10,000 Men ≥50 Years of Age: Vertebral Fracture Outcomes by 5-Year Intervals
Age Group (years) 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85–89 Sensitivity 0.288 0.467 0.878 0.823 0.71 0.839 0.851 0.751 Specificity 0.898 0.637 0.671 0.618 0.497 0.472 0.31 0.227 Base/Case Assumptions per 10,000 5-yr risk of vertebral fracture*35 0.006 0.008 0.010 0.013 0.017 0.021 0.021 0.014 Osteoporosis risk30 0.050 0.051 0.039 0.026 0.035 0.051 0.055 0.025 Relative risk for vertebra fracture w/Rx34 0.52 0.52 0.52 0.52 0.52 0.52 0.52 0.52 Adherence to Rx, proportion34 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 Results, per 10,000 men (n) Predicted cases of osteoporosis (n) 501.6 513.1 394.2 263.8 345.0 508.6 549.7 248.3 MORES TP 144.5 239.6 346.1 217.1 245.0 426.7 467.8 186.5 MORES FN 357.2 273.5 48.1 46.7 100.1 81.9 81.9 61.8 MORES TN 8529.5 6043.1 6445.5 6017.0 4798.5 4480.0 2929.6 2213.6 MORES FP 968.8 3443.7 3160.3 3719.2 4856.5 5011.5 6520.7 7538.1 Referred for DXA (TP + FP) 1113.3 3683.4 3506.4 3936.3 5101.4 5438.2 6988.5 7724.5 Predicted Vertebral Fx: MORES/DXA screening (n) TP with Rx 0.60 1.24 2.18 1.87 2.81 5.81 6.52 1.67 FN with no Rx 2.25 2.13 0.46 0.61 1.73 1.68 1.72 0.83 Total Fx with Rx after screening 2.85 3.37 2.64 2.48 4.54 7.49 8.24 2.51 Unscreened, untreated 3.16 4.00 3.74 3.43 5.97 10.43 11.54 3.35 NNS MORES: DXA 3641 5866 3175 4151 3583 1851 2118 9134 NNT MORES: DXA 1641 818 357 279 243 174 167 294 Universal DXA screening (n) Fracture with Rx 2.10 2.66 2.49 2.28 3.96 6.92 7.66 2.23 Fracture with no Rx 3.16 4.00 3.74 3.43 5.97 10.43 11.54 3.35 NNS universal DXA 9418 7437 7949 8678 4987 2855 2579 8880 NNT universal DXA 473 382 314 229 173 146 142 221 * Mean, 10 years risk across age groups ÷ 2.
MORES, Male Osteoporosis Risk Estimation Score; Rx, bisphosphonate therapy; TP, true positives; FN, false negatives; TN, true negatives; FP, false positives; DXA, done densitometry; NNS, number needed to screen to prevent one additional vertebral fracture; NNT, number needed to treat to prevent one additional vertebral fracture; Fx, fracture.
