Who should receive bone mineral density testing?

Evidence A study of 860 postmenopausal Asian women examined 11 risk factors to predict osteoporosis1: • Multiple risk factors had minimal value over age and weight alone. • The OST was developed based on weight and age. Eight systematic reviews were conducted from 2007 to 2015, with up to 108 studies and 208 738 patients evaluating more than 9 tools to assess the risk of osteoporosis or fractures.2-9 • The OST performed at least as well as other tools.2-9 For example: -The OST performs moderately well at identifying femoral neck osteoporosis (sensitivity 89%, specificity 41%) in postmenopausal white women.9 • Tools with fewer risk factors (eg, OST) predict osteoporosis as well as or better than those with more factors.3,4,7-9 -No tool was clearly superior.3,4,8 • Unlike other tools to assess the risk of osteoporosis, the OST has been validated in both sexes and in several races.6,9 • The included studies had methodologic limitations.2-9