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To the Editor: Ms Cadarette and colleagues¹ evaluated 4 decision rules to determine who should be screened for osteoporosis by dual-energy x-ray absorptiometry (DXA). It is important to screen women at risk for osteoporosis because of the marked increase in morbidity and mortality associated with this disease, but also not to screen those women at low risk because of the increased cost.

The authors evaluated my decision rule (ABONE)² against other decision rules including their own screening tool. The authors determined that the sensitivity of ABONE was 79.1% (95% confidence interval [CI], 75.9%-82.3%) for identifying women with a T score of -2 or less compared with SCORE (sensitivity, 97.5%; 95% CI, 96.3%-98.8%) and ORAI (the authors' decision rule) (sensitivity, 94.2%; 95% CI, 92.3%-96.1%). ABONE found the least number of women with normal bone mineral density (BMD) at 35.8% (95% CI, 32.4%-39.2%), with SCORE identifying 69.2% (95% CI, 65.9%-72.5%) and ORAI . . . [Full Text of this Article]

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RELATED ARTICLE

Evaluation of Decision Rules for Referring Women for Bone Densitometry by Dual-Energy X-ray Absorptiometry
Suzanne M. Cadarette, Susan B. Jaglal, Timothy M. Murray, Warren J. McIsaac, Lawrence Joseph, Jacques P. Brown, and for the Canadian Multicentre Osteoporosis Study
JAMA. 2001;286(1):57-63.
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