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Background. Dual-energy X-ray absorbtiometry (DXA) is the most accurate method to identify subjects with low bone mineral density (BMD), but it is expensive and with limited availability in some communities. Therefore, identification of the subjects at risk for low BMD based on clinical decision rules could be a reasonable alternative to limit DXA referral.

Objectives. To asses the performance of five indices combining different clinical risk factors as a decision rules for DXA referral. Methods. The study included postmenopausal women referred for DXA scanning by the GPs or hospital-based clinic based on the presence of one or more risk factors for osteoporosis. All patients were evaluated by DXA performed at lumbar spine and total hip (Prodigy Advance Lunar-GE) and QUS (Sahar Hologic). Five osteoporosis risk indices were calculated: OST, ORAI, OSIRIS, OPERA, SCORE. Results. 140 postmenopausal women …