Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women

Sun Min Oh, Byung Ho Nam, Yumie Rhee, Seong Hwan Moon, Deog Young Kim, Dae Ryong Kang, Hyeon Chang Kim

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Currently, dual-energy X-ray absorptiometry (DXA) is the gold standard for detecting osteoporosis, but is not recommended for general population screening. Therefore, this study aims to develop an osteoporosis risk-assessment model to identify high-risk individuals among Korean postmenopausal women. Data from 1,209 and 1,046 postmenopausal women who participated in the 2009 and 2010 Korean National Health and Nutrition Examination Survey, respectively, were used for development and validation of an osteoporosis risk-assessment model. Osteoporosis was defined as T score less than or equal to -2.5 at either the femoral neck or lumbar spine. Performance of the candidate models and the Osteoporosis Self assessment Tool for Asians (OSTA) were compared with respect to sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). To compare the developed Korean Osteoporosis Risk-Assessment Model (KORAM) with OSTA, a net reclassification improvement was further calculated. In the development dataset, the prevalence of osteoporosis was 33.9 %. KORAM, consisting of age, weight, and hormone therapy, had a sensitivity of 91.2 %, a specificity of 50.6 %, and an AUC of 0.709 with a specific cut-off score of -9. Comparable results were shown in the validation dataset: sensitivity 84.8 %, specificity 51.6 %, and AUC 0.682. Additionally, risk categorization with KORAM showed improved reclassification over that of OSTA from 7.4 to 41.7 %. KORAM can be easily used as a pre-screening tool to identify candidates for DXA tests. Further studies investigating cost-effectiveness and replicability in other datasets are required to establish the clinical utility of KORAM.

Original languageEnglish
Pages (from-to)423-432
Number of pages10
JournalJournal of Bone and Mineral Metabolism
Issue number4
Publication statusPublished - 2013 Jul

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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