The Canadian Score (TM) questionnaire - Optimizing the use of technology for low bone density assessment

The Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire is a tool to assist physicians to identify women who might require bone densi tometry. The purpose of this study was to develop a Canadian SCORE and to a ssess validity and reliability. Twenty sites enrolled 307 postmenopausal wo men ages 50-70 yr. SCORE, results were compared to hip and lumbar spine bon e density assessed by dual X-ray absorptiometry. Sensitivity and specificit y of a range of SCORE cut-points were assessed in a receiver operating char acteristics analysis to determine the optimal cut-point for SCORE. With low bone density defined as a T-score less than or equal to - 2.0, a SCORE cut -point of 6 in women ages 50-59 yr displayed a sensitivity of 0.96, 95% con fidence interval (CI) (0.89, 1.00), and a specificity of 0.51, 95% CI (0.43 , 0.58). In women ages 60-70 yr, a SCORE cut-point of 8 displayed a sensiti vity of 0.90, 95% CI (0.80, 0.97) and a specificity of 0.20, 95% CI (0.11, 0.29). The Lest-retest reliability (intraclass correlation coefficient) was 0.95. SCORE performed better in women in their fifties than women in their sixties. Older women require higher SCORE cut-points. The use of SCORE as an initial measure for identifying those at risk for osteoporosis may reduc e costs by limiting unnecessary tests.