Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis
Objectives: To enhance the public awareness and facilitate diagnosis of osteoporosis, we aim to develop a new Chinese Osteoporosis Screening Algorithm (COSA) to identify people at high risk of osteoporosis. Methods: A total of 4747 postmenopausal women and men aged ≥ 50 from the Hong Kong Osteoporos...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Osteoporosis and Sarcopenia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405525523000109 |
| _version_ | 1797850449088348160 |
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| author | Ching-Lung Cheung Gloria HY. Li Hang-Long Li Constance Mak Kathryn CB. Tan Annie WC. Kung |
| author_facet | Ching-Lung Cheung Gloria HY. Li Hang-Long Li Constance Mak Kathryn CB. Tan Annie WC. Kung |
| author_sort | Ching-Lung Cheung |
| collection | DOAJ |
| description | Objectives: To enhance the public awareness and facilitate diagnosis of osteoporosis, we aim to develop a new Chinese Osteoporosis Screening Algorithm (COSA) to identify people at high risk of osteoporosis. Methods: A total of 4747 postmenopausal women and men aged ≥ 50 from the Hong Kong Osteoporosis Study were randomly split into a development (N = 2373) and an internal validation cohort (N = 2374). An external validation cohort comprising 1876 community-dwelling subjects was used to evaluate the positive predictive value (PPV). Results: Among 11 predictors included, age, sex, weight, and history of fracture were significantly associated with osteoporosis after correction for multiple testing. Age- and sex-stratified models were developed due to the presence of significant sex and age interactions. The area under the curve of the COSA in the internal validation cohort was 0.761 (95% CI, 0.711–0.811), 0.822 (95% CI, 0.792–0.851), and 0.946 (95% CI, 0.908–0.984) for women aged < 65, women aged ≥ 65, and men, respectively. The COSA demonstrated improved reclassification performance when compared to Osteoporosis Self-Assessment Tool for Asians. In the external validation cohort, the PPV of COSA was 40.6%, 59.4%, and 19.4% for women aged < 65, women aged ≥ 65, and men, respectively. In addition, COSA > 0 was associated with an increased 10-year risk of hip fracture in women ≥ 65 (OR, 4.65; 95% CI, 2.24–9.65) and men (OR, 11.51; 95% CI, 4.16–31.81). Conclusions: We have developed and validated a new osteoporosis screening algorithm, COSA, specific for Hong Kong Chinese. |
| first_indexed | 2024-04-09T19:01:24Z |
| format | Article |
| id | doaj.art-99ec166dbfb74195ac26e24512665519 |
| institution | Directory Open Access Journal |
| issn | 2405-5255 |
| language | English |
| last_indexed | 2024-04-09T19:01:24Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoporosis and Sarcopenia |
| spelling | doaj.art-99ec166dbfb74195ac26e245126655192023-04-08T05:12:50ZengElsevierOsteoporosis and Sarcopenia2405-52552023-03-0191813Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosisChing-Lung Cheung0Gloria HY. Li1Hang-Long Li2Constance Mak3Kathryn CB. Tan4Annie WC. Kung5Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Corresponding author. Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong.Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong KongDepartment of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong KongDepartment of Pharmacology and Pharmacy, The University of Hong Kong, Hong KongDepartment of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong KongDepartment of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong KongObjectives: To enhance the public awareness and facilitate diagnosis of osteoporosis, we aim to develop a new Chinese Osteoporosis Screening Algorithm (COSA) to identify people at high risk of osteoporosis. Methods: A total of 4747 postmenopausal women and men aged ≥ 50 from the Hong Kong Osteoporosis Study were randomly split into a development (N = 2373) and an internal validation cohort (N = 2374). An external validation cohort comprising 1876 community-dwelling subjects was used to evaluate the positive predictive value (PPV). Results: Among 11 predictors included, age, sex, weight, and history of fracture were significantly associated with osteoporosis after correction for multiple testing. Age- and sex-stratified models were developed due to the presence of significant sex and age interactions. The area under the curve of the COSA in the internal validation cohort was 0.761 (95% CI, 0.711–0.811), 0.822 (95% CI, 0.792–0.851), and 0.946 (95% CI, 0.908–0.984) for women aged < 65, women aged ≥ 65, and men, respectively. The COSA demonstrated improved reclassification performance when compared to Osteoporosis Self-Assessment Tool for Asians. In the external validation cohort, the PPV of COSA was 40.6%, 59.4%, and 19.4% for women aged < 65, women aged ≥ 65, and men, respectively. In addition, COSA > 0 was associated with an increased 10-year risk of hip fracture in women ≥ 65 (OR, 4.65; 95% CI, 2.24–9.65) and men (OR, 11.51; 95% CI, 4.16–31.81). Conclusions: We have developed and validated a new osteoporosis screening algorithm, COSA, specific for Hong Kong Chinese.http://www.sciencedirect.com/science/article/pii/S2405525523000109OsteoporosisPredictionCohortFractureAssociation |
| spellingShingle | Ching-Lung Cheung Gloria HY. Li Hang-Long Li Constance Mak Kathryn CB. Tan Annie WC. Kung Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis Osteoporosis and Sarcopenia Osteoporosis Prediction Cohort Fracture Association |
| title | Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis |
| title_full | Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis |
| title_fullStr | Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis |
| title_full_unstemmed | Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis |
| title_short | Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis |
| title_sort | development and validation of the chinese osteoporosis screening algorithm cosa in identification of people with high risk of osteoporosis |
| topic | Osteoporosis Prediction Cohort Fracture Association |
| url | http://www.sciencedirect.com/science/article/pii/S2405525523000109 |
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