Reliability of a Risk-Factor Questionnaire for Osteoporosis: A Primary Care Survey Study with Dual Energy X-ray Absorptiometry Ground Truth

Maria Radeva, Dorothee Predel, Sven Winzler, Ulf Teichgräber, Alexander Pfeil, Ansgar Malich and Ismini Papageorgiou
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Maria Radeva: Institute of Diagnostic and Interventional Radiology, Jena University Hospital—Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
Dorothee Predel: Institute of Radiology, Suedharz Hospital Nordhausen, Dr.-Robert-Koch-Str. 39, 99734 Nordhausen, Germany
Sven Winzler: Institute of Radiology, Suedharz Hospital Nordhausen, Dr.-Robert-Koch-Str. 39, 99734 Nordhausen, Germany
Ulf Teichgräber: Institute of Diagnostic and Interventional Radiology, Jena University Hospital—Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
Alexander Pfeil: Department of Internal Medicine III, Jena University Hospital—Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
Ansgar Malich: Institute of Radiology, Suedharz Hospital Nordhausen, Dr.-Robert-Koch-Str. 39, 99734 Nordhausen, Germany
Ismini Papageorgiou: Institute of Diagnostic and Interventional Radiology, Jena University Hospital—Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany

IJERPH, 2021, vol. 18, issue 3, 1-14

Abstract: (1) Purpose: Predisposing factors to osteoporosis (OP) as well as dual-source x-ray densitometry (DXA) steer therapeutic decisions by determining the FRAX index. This study examines the reliability of a standard risk factor questionnaire in OP-screening. (2) Methods: n = 553 eligible questionnaires encompassed 24 OP-predisposing factors. Reliability was assessed using DXA as a gold standard. Multiple logistic regression and Spearman’s correlations, as well as the confounding influence of age and body mass index, were analyzed in SPSS (IBM Corporation, Armonk, NY, USA). (3) Results: Our study revealed low patient self-awareness regarding OP and its risk factors. One out of every four patients reported a positive history for osteoporosis not confirmed by DXA. The extraordinarily high incidence of rheumatoid arthritis and thyroid disorders likely reflect confusion with other diseases or health anxiety. FRAX-determining risk factors such as malnutrition, liver insufficiency, prior fracture without trauma, and glucocorticoid therapy did not correlate with increased OP incidence, altogether demonstrating how inaccurate survey information could influence therapeutic decisions on osteoporosis. (4) Conclusions: Contradictive results and a low level of patient self-awareness suggest a high degree of uncertainty and low reliability of the current OP risk factor survey.

Keywords: osteoporosis; survey; bias; FRAX; patient management; self-awareness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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