Questionnaire for Low Bone Density
Although bone mass is now able to be assessed accurately, easily, safely, and relatively inexpensively by a variety of techniques, a simple tool to discern women at risk is not yet in routine use. The magnitude of the osteoporosis at-risk population, and the gravity of its consequences, have prompted renewed vigor in enhancing our selection processes for screening among the general population of female patients. The authors developed a questionnaire, the Simple Calculated Osteoporosis Risk Estimate (SCORE), which would identify osteoporosis at-risk women who would be more likely to benefit from assessment of bone mass.
From an initial pool of more than 350 variables from patient demographics, body measurements, lifestyle, reproductive history, additional medical history, and current/past medications, 1600 female subjects participated in a progressive refinement of the available paths of inquiry. SCORE variables finally included race, presence of rheumatoid arthritis, history of fractures, age, estrogen use, and weight. Defining low bone mineral density as more than 2.5 standard deviations below the mean, a point score of 7 or greater has a 90% sensitivity for osteoporosis (a simple scoring system is detailed on the questionnaire).
The authors have devised a simple questionnaire clinicians can use to refine the scope of which female patients most directly merit investigation of bone mineral density. A similar tool for use with at-risk males would be welcomed.
Lydick E, et al. Am J Man Care 1998; 4:37-48.
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