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.