Development and Validation of a New Clinical Risk Index for Prediction of Osteoporosis in Thai Women
Chatlert Pongchaiyakul MD*, Nguyen D Nguyen MD**, Choowong Pongchaiyakul BSc***, Tuan V Nguyen PhD**
Affiliation : * Department of Medicine, Faculty of Medicine, Khon Kaen University ** Bone and Mineral Research Program, Garvan Institute of Medical Research, Sydney, Australia. *** Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
The objective of this study was to develop and validate a new simple tool for identifying Thai women who are at high risk of having osteoporosis. A total of 322 women, aged > 45 years, were randomly divided into two cohorts: a development (n = 130) and a validation cohort (n = 192). Femoral neck and lumbar spine BMD were measured by LUNAR DPX-IQ densitometer. The prevalence of osteoporosis (defined by BMD T-scores < -2.5) was 33 per cent by either femoral neck or lumbar spine BMD. Khon Kaen Osteoporosis Study (KKOS), scoring based on age and weight was calculated and applied to the development cohort. Individuals with KKOS score < -1 were defined as “high risk”; otherwise a “low risk” was defined. In the validation cohort, the sensitivity and specificity of KKOS was 70 and 73 per cent, respectively. Furthermore, if the high risk individuals identified by KKOS are to be treated, and if the treatment reduces fracture incidence by 50 per cent and assuming that treatment cost is 10 bahts per day, then the cost to prevent one fracture is estimated to be 466,695 bahts per year. These data suggest that although age and body weight can be used to identify Thai women who are at high risk of having osteoporosis, its application to the general population requires further research to arrive at the optimal cost-benefit for the community.
Keywords : Clinical Risk Index, Osteoporosis, Fracture, Asia, Thailand
