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研究生:李欣岱
研究生(外文):Hsin-Dai Lee
論文名稱:定量式超音波檢查儀篩檢老人不正常骨質密度及骨折之效度
論文名稱(外文):Validation of Quantitative Ultrasound for Screening Abnormal Bone Density and Fractures in Older People
指導教授:林茂榮林茂榮引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:傷害防治學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:英文
論文頁數:24
中文關鍵詞:雙能量X光吸收儀 老人 骨質疏鬆症 定量式超音波檢查儀 篩檢
外文關鍵詞:DXA Older people Osteoporosis QUS Screening
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Purpose: This study examined convergent, criterion, and discriminant validity of quantitative ultrasound (QUS), as compared to dual-energy X-ray absorptiometry (DXA), for identifying abnormal bone density and fractures among older people in Taiwan.
Methods: Four hundred and fifty three community-dwelling, healthy older people aged 55 years participated in the study. Additional 31 subjects who visited emergency room due to fragility fractures were also recruited for validating discriminant ability. In addition to personal interviews collecting information on demographic, osteoporosis, and fall-related variables for these subjects, assessment of bone density using both calcaneal QUS and femoral neck DXA methods were conducted. Two parameters of the QUS, speed of sound (SOS) and broadband ultrasound attenuation (BUA), were used to estimate heel bone mineral density (BMD) and T-scores, as compared with the DXA. By the World Health Organization''s criteria for abnormal bone density, thresholds of T-scores of -1.0 and -2.5 were used to define low bone density and osteoporosis.
Results: For convergent validity, Pearson''s correlation coefficients between femoral neck DXA BMD and three calcaneal QUS parameters (BUA, SOS, and estimated heel BMD) ranged from 0.48 to 0.49. Using femoral neck DXA as the criterion, the sensitivity and specificity of calcaneal QUS to screen for abnormal bone density were 67.2% and 56.9%, respectively; the counterparts for osteoporosis were 29.0% and 93.1%. The ability of the BUA and estimated heel BMD of QUS to discriminate between subjects with and without fragility fractures was statistically significant, while the SOS did not; furthermore, unadjusted and adjusted AUC (for age, gender, and falls history) of the estimated heel BMD of QUS to discriminate between the two groups was 0.645 and 0.939, in contrast to 0.641 and 0.945 of the DXA.
Conclusion: Compared with DXA, QUS has acceptable convergent and discriminant validity but poor criterion validity. However, QUS and DXA may measure different dimensions of BMD.
目 錄
中文摘要..................................................I
英文摘要................................................III
目錄......................................................V
本文目錄.................................................VI
圖表目錄................................................VII
VI
本 文 目 錄
Introduction ……………………………………………………….. 1
Methods
Subjects ………………………………………………………… 4
Personal interviews and examinations …………………………. 4
Densitometry ………………………………………………….. . 5
Statistical analysis…………………………………………………. 7
Results.…………………………………………………………….. 8
Discussion…………………………………………………………..10
Conclusion………………………………………………………… 13
References…………………………………………………………. 14
VII
圖 表 目 錄
Figure1.Flow diagram of study subjects, healthy group .........................18
Figure 2.The area under the receiver’s operating characteristics curve
(AUC) with and without adjustment for age, gender, and falls
history in the past year………………………………………….19
Table 1.Baseline characteristics of 129 subjects who attended health
check-up and 324 volunteers.......................................................20
Table 2.Convergent validity: Pearson’s correlation coefficients between
BUA, SOS, and estimated heel BMD of calcaneal QUS and
femoral neck DXA......................................................................22
Table 3.Criterion validity of the calcaneal QUS according to femoral neck
DXA............................................................................................23
Table 4.Discriminant ability of calcaneal QUS and femoral neck DXA
measures with regard to fracture status.......................................24
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