{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:26:05Z","timestamp":1792513565884,"version":"4.5.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-111-174"],"award-info":[{"award-number":["DMR-111-174"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study compares Osteoporosis Self-Assessment Tool for Asians (OSTA) and Calcaneal Quantitative Ultrasound (QUS) to detect primary osteoporosis among Taiwanese postmenopausal women and assess the consistency between both methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>8,883 postmenopausal women were selected from Taiwan Biobank. Osteoporosis was diagnosed using Dual-energy X-ray absorptiometry (DXA) with T-score\u2266-2.5 under WHO definition. QUS and OSTA were employed to assess osteoporosis risk, with statistical analyses including receiver operating characteristic curve (ROC) analysis, Delong\u2019s test, and McNemar\u2019s test to compare the performance of both tools. Youden\u2019s J statistic identifies the optimal cut-off values of OSTA and QUS SI. Cohen\u2019s kappa coefficient (k) and Spearman\u2019s rank correlation coefficient (r<jats:sub>s<\/jats:sub>) assessed the correlation between OSTA, QUS, and DXA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>QUS outperformed OSTA with superior AUC in primary osteoporosis screening of Taiwanese postmenopausal women under WHO osteoporosis definition (AUC of QUS and OSTA are 0.737 and 0.703; p&amp;lt;0.05). They could independently screen and track the women at primary osteoporosis risk but not replace DXA for osteoporosis diagnosis, because they had a fair agreement of k (0.293~0.342) and a moderate correlation of r<jats:sub>s<\/jats:sub> (0.424~0.481) with DXA. They couldn\u2019t screen and track the women at primary osteoporosis risk interchangeably because their agreement is minimal (k=0.197; r<jats:sub>s<\/jats:sub>=0.271; p&amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>QUS and OSTA are radiation-free, portable, less expensive and time-consuming, and effective screening tools for primary osteoporosis in Taiwanese postmenopausal women, with QUS being the superior method under WHO osteoporosis definition. After further age-stratified analysis for detecting primary osteoporosis in Taiwanese postmenopausal women, QUS outperformed OSTA in those aged 45 - 65, while OSTA outperformed QUS in those aged 66 - 80.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1639176","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:59:51Z","timestamp":1757678391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Osteoporosis self-assessment tool for Asians and calcaneal quantitative ultrasound for identifying primary osteoporosis in Taiwanese postmenopausal women"],"prefix":"10.3389","volume":"16","author":[{"given":"Dung-Huan","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Sheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Ching","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"B1","article-title":"World population ageing 2015 - highlights (ST\/ESA\/SER.A\/368)","year":"2015"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(01)00614-7","article-title":"Epidemiology of fractures in England and Wales","volume":"29","author":"Van Staa","year":"2001","journal-title":"Bone"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.100771","article-title":"2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary","volume":"182","author":"Papaioannou","year":"2010","journal-title":"Cmaj"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67604-0","article-title":"Prevention of falls and consequent injuries in elderly people","volume":"366","author":"Kannus","year":"2005","journal-title":"Lancet"},{"key":"B5","article-title":"Clinical applications of bone density testing for osteoporosis","volume":"96","author":"Lewiecki","year":"2005","journal-title":"Minerva Medica"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-014-2655-z","article-title":"The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group","volume":"25","author":"Siris","year":"2014","journal-title":"Osteoporos Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.ultrasmedbio.2010.10.003","article-title":"Identifying elderly women with osteoporosis by spinal dual X-ray absorptiometry, calcaneal quantitative ultrasound and spinal quantitative computed tomography: a comparative study","volume":"37","author":"Edelmann-Sch\u00e4fer","year":"2011","journal-title":"Ultrasound Med Biol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1007\/s001980170070","article-title":"A simple tool to identify Asian women at increased risk of osteoporosis","volume":"12","author":"Koh","year":"2001","journal-title":"Osteoporos Int"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2008.07.003","article-title":"Identifying women with low bone mass: a systematic review of screening tools","volume":"30","author":"McLeod","year":"2009","journal-title":"Geriatr Nursing"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1956","article-title":"Risk assessment tools to identify women with increased risk of osteoporotic fracture: complexity or simplicity? 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