Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study
Existing osteoporosis screening tools have limitations, including using race as a predictor, and development on homogeneous samples. This biases risk assessment of osteoporosis in diverse populations and increases health inequities. We develop a tool that relies on variables easily learned during po...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023110140 |
| _version_ | 1797336984228724736 |
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| author | Margaret Gough Courtney Josephine Roberts K. Godde |
| author_facet | Margaret Gough Courtney Josephine Roberts K. Godde |
| author_sort | Margaret Gough Courtney |
| collection | DOAJ |
| description | Existing osteoporosis screening tools have limitations, including using race as a predictor, and development on homogeneous samples. This biases risk assessment of osteoporosis in diverse populations and increases health inequities. We develop a tool that relies on variables easily learned during point-of-care, known by individuals, and with negligible racial bias. Data from the 2012–2016 waves of the population-based cohort Health and Retirement Study (HRS) were used to build a predictive model of osteoporosis diagnosis on a 75 % training sample of adults ages 50–90. The model was validated on a 25 % holdout sample and a cross-sectional sample of American individuals ages 50–80 from the National Health and Nutrition Examination Survey (NHANES). Sensitivity and specificity were compared across sex and race/ethnicity. The model has high sensitivity in the HRS holdout sample (89.9 %), which holds for those identifying as female and across racial/ethnic groups. Specificity is 57.9 %, and area under the curve (AUC) is approximately 0.81. Validation in the NHANES sample using empirically measured osteoporosis produced relatively good values of sensitivity, specificity, and consistency across groups. The model was used to create a publicly-available, open-source tool called the Osteoporosis Health Equality (& Equity) Evaluation (OsteoHEE). The model provided high sensitivity for osteoporosis diagnosis, with consistently high results for those identifying as female, and across racial/ethnic groups. Use of this tool is expected to improve equity in screening and increase access to bone density scans for those at risk of osteoporosis. Validation on alternative samples is encouraged. |
| first_indexed | 2024-03-08T09:02:48Z |
| format | Article |
| id | doaj.art-be45d5fd8c114497aedc9033e46e0a28 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T09:02:48Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-be45d5fd8c114497aedc9033e46e0a282024-02-01T06:33:37ZengElsevierHeliyon2405-84402024-01-01101e23806Development of a diverse osteoporosis screening tool for older US adults from the health and retirement studyMargaret Gough Courtney0Josephine Roberts1K. Godde2Department of Sociology and Anthropology, University of La Verne, 1950 Third St., La Verne, CA, USADepartment of Sociology and Anthropology, University of La Verne, 1950 Third St., La Verne, CA, USACorresponding author.; Department of Sociology and Anthropology, University of La Verne, 1950 Third St., La Verne, CA, USAExisting osteoporosis screening tools have limitations, including using race as a predictor, and development on homogeneous samples. This biases risk assessment of osteoporosis in diverse populations and increases health inequities. We develop a tool that relies on variables easily learned during point-of-care, known by individuals, and with negligible racial bias. Data from the 2012–2016 waves of the population-based cohort Health and Retirement Study (HRS) were used to build a predictive model of osteoporosis diagnosis on a 75 % training sample of adults ages 50–90. The model was validated on a 25 % holdout sample and a cross-sectional sample of American individuals ages 50–80 from the National Health and Nutrition Examination Survey (NHANES). Sensitivity and specificity were compared across sex and race/ethnicity. The model has high sensitivity in the HRS holdout sample (89.9 %), which holds for those identifying as female and across racial/ethnic groups. Specificity is 57.9 %, and area under the curve (AUC) is approximately 0.81. Validation in the NHANES sample using empirically measured osteoporosis produced relatively good values of sensitivity, specificity, and consistency across groups. The model was used to create a publicly-available, open-source tool called the Osteoporosis Health Equality (& Equity) Evaluation (OsteoHEE). The model provided high sensitivity for osteoporosis diagnosis, with consistently high results for those identifying as female, and across racial/ethnic groups. Use of this tool is expected to improve equity in screening and increase access to bone density scans for those at risk of osteoporosis. Validation on alternative samples is encouraged.http://www.sciencedirect.com/science/article/pii/S2405844023110140Bone densityDisease screeningEquity |
| spellingShingle | Margaret Gough Courtney Josephine Roberts K. Godde Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study Heliyon Bone density Disease screening Equity |
| title | Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study |
| title_full | Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study |
| title_fullStr | Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study |
| title_full_unstemmed | Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study |
| title_short | Development of a diverse osteoporosis screening tool for older US adults from the health and retirement study |
| title_sort | development of a diverse osteoporosis screening tool for older us adults from the health and retirement study |
| topic | Bone density Disease screening Equity |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023110140 |
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