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Screening for Osteoporosis in Men: A Systematic Review for an American College of Physicians Guideline
- Hau Liu, MD, MBA, MPH;
- Neil M. Paige, MD, MSHS;
- Caroline L. Goldzweig, MD, MSHS;
- Elaine Wong, MD;
- Annie Zhou, MS;
- Marika J. Suttorp, MS;
- Brett Munjas, BA;
- Eric Orwoll, MD; and
- Paul Shekelle, MD, PhD
- From Santa Clara Valley Medical Center, San Jose, California; Center for Primary Care and Outcomes Research, Stanford University, Stanford, California; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; RAND Corporation, Santa Monica, California; and Oregon Health & Science University, Portland, Oregon.
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Figure 1. Study flow diagram.Some articles assessed multiple risk factors. A total of 614 titles were identified for review; 20 articles evaluated male osteoporosis screening tools and were included in the analysis. BMD = bone mineral density; PSA = prostate-specific antigen.
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Figure 2. Receiver-operating characteristic curves for calcaneal ultrasonography (left) and the Osteoporosis Self-Assessment Screening Tool (OST) (right) in identifying dual-energy x-ray absorptiometry (DXA)–determined osteoporosis.The plotted curves were derived from abstracted data of included studies for calcaneal ultrasonography and OST against DXA as the reference standard. QUI = quantitative ultrasound index. *Threshold for positive test result: central DXA T-score = −1.5. †Threshold for positive test result: central DXA T-score = −2.0. ‡Threshold for positive test result: central DXA T-score = −2.5. §Threshold for positive test result: calcaneal ultrasonography T-score = −1.0. ∥Threshold for positive test result: bone mineral density T-score = −2.0. ¶Threshold for positive test result: bone mineral density T-score = −2.5. **Threshold for positive test result: OST score = −1.0.
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