Abstract:
Objectives: This study aims to develop and validate a country specific osteoporosis risk assessing tool for
Sri Lankan postmenopausal women.
Methods: Community-dwelling postmenopausal women were enrolled to development (n ¼ 602) and
validation (n ¼ 339) samples. Clinical risk factors (CRFs) of osteoporosis were assessed. Bone mineral
densities (BMD) of femoral neck, total hip and lumbar spine were assessed by dual energy X-ray ab sorptiometry (DXA) scan. Radial ultrasound (US) bone scan was done. Linear regression analysis was
performed in development sample considering regional BMDs as dependent and CRFs as independent
variables. Regression equations were developed to estimate regional BMDs using best predictive CRFs.
Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were assessed to validate
the new tools.
Results: Age, body weight and US T-scores showed positive correlations with BMDs of all 3 sites. Two
osteoporosis risk assessing tools (OPRATs) were developed as OPRAT-1 and OPRAT-2. Prevalence of
osteoporosis, in the validation sample was 74.3%. Sensitivity were high in both tools (OPRAT-1 and
OPRAT-2; 83.2% and 82.5%) while specificity were moderate (44.8% for both). PPV of OPRAT-1 and OPRAT 2 were 79.5% and 81.2%. Both tools showed moderate NPV (OPRAT-1 and OPRAT-2; 51% and 47%).
Conclusions: Both OPRAT-1 and OPRAT-2 have high performance in screening postmenopausal women in
Sri Lanka for risk of osteoporosis. OPRAT-2 is more convenient and can be used in any healthcare setting
with limited resources to identify women who will be benefitted by DXA. OPRAT-1 can be used if the
radial US facility is available.
