Accuracy in osteoporosis diagnosis of a combination of mandibular cortical width measurement on dental panoramic radiographs and a clinical risk index (OSIRIS): the OSTEODENT project

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Accuracy in osteoporosis diagnosis of a combination of mandibular cortical width measurement on dental panoramic radiographs and a clinical risk index (OSIRIS): the OSTEODENT project

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dc.contributor.author Karayianni, Kety
dc.contributor.author Horner, Keith
dc.contributor.author Mitsea, Anastasia
dc.contributor.author Berkas, Leonidas
dc.contributor.author Mastoris, Michael
dc.contributor.author Jacobs, Reinhilde
dc.contributor.author Lindh, Christina
dc.contributor.author van der Stelt, Paul F
dc.contributor.author Harrison, Elizabeth
dc.contributor.author Adams, Judith
dc.contributor.author Pavitt, Susan
dc.contributor.author Devlin, Hugh
dc.date.accessioned 2007-02-19T16:07:16Z
dc.date.available 2007-02-19T16:07:16Z
dc.date.issued 2007
dc.identifier.issn 8756-3282
dc.identifier.uri http://hdl.handle.net/2043/3657
dc.description.abstract Clinical questionnaires and dental radiographic findings have both been suggested as methods of identifying women at risk of having osteoporosis and who might benefit from bone densitometry. The aim of this study was to measure the diagnostic accuracy of a combination of mandibular cortical width (MCW) measured from dental panoramic radiographs (DPRs) and the osteoporosis index of risk (OSIRIS) in the diagnosis of osteoporosis. 653 women (age range 45-70 years, mean age 54.95 years) in four European centres underwent standardised dual X-ray energy absorptiometry (DXA) to provide reference data on osteoporosis status. Each subject was interviewed to derive OSIRIS scores and underwent DPR examination. MCW was measured directly by five observers. Receiver Operating Characteristic (ROC) curve analysis was used to calculate sensitivities and specificities of the clinical and radiographic tests for the diagnosis of osteoporosis. 512 (78.4%) of the study population were classified as having normal BMD and 141 (21.6%) as having osteoporosis. Using ROC analysis, OSIRIS gave a ROC curve area (A(z)) of 0.838, with a sensitivity of 70.9% and a specificity of 79.5% at a diagnostic threshold of <or=+1. MCW on DPRs gave Az values for the five observers ranging from 0.71 to 0.78, providing sensitivities between 41.0% and 59.6% and specificities of between 81.8% and 90.3% at a diagnostic threshold of a 3 mm MCW and sensitivities between 94.2% and 99.3% and specificities of between 9.8% and 23.7% at a diagnostic threshold of a 4.5 mm MCW. Inter-observer repeatability was less than 2.15 mm for 95% of subjects. Combining clinical and radiographic tests had the effect of improving specificity at the expense of a fall in sensitivity. Diagnostic thresholds for MCW and OSIRIS can be chosen to provide the sensitivity and specificity combination that best suits locally determined needs. However, the addition of OSIRIS as a stepwise 'follow-up' test to radiographic assessment of MCW should only be performed if the aim is to have a test for which the highest achievable specificity is desired. en
dc.format.extent 7
dc.language.iso eng en
dc.publisher Elsevier
dc.subject.classification Medicine en
dc.title Accuracy in osteoporosis diagnosis of a combination of mandibular cortical width measurement on dental panoramic radiographs and a clinical risk index (OSIRIS): the OSTEODENT project en
dc.type Article, peer reviewed scientific en
dc.identifier.paperprint 0 en
dc.contributor.department Malmö University. Faculty of Odontology en
dc.identifier.doi 10.1016/j.bone.2006.07.025
dc.relation.ispartofpublication Bone;1
dc.relation.ispartofpublicationvolume 40 en
dc.format.ePage 229
dc.format.sPage 223
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