The aim of our study was to evaluate the difference and agreement between quantitative ultrasound (QUS) and dual X-ray absorptiometry (DXA) using statistical method, which is suitable for the health examination. Ninety-eight consecutive patients (female, 49±12 years old) of perimenopause were examined in this study. DXA of the lumbar spine was performed to acquire the BMD values and were expressed as T-score. At the same session, the calcaneus of the same patients was examined with QUS. Paired T-test and linear regression were performed to observe the relationship between QUS and DXA. The level of agreement was analyzed with weighted kappa (wk) statistics. The paired T-test for comparison of T-score of DXA and QUS showed t-value about 5.943 (P<0.001), which was statistical significance. Pearson's correlation coefficient for the comparison of QUS with DXA was R=0.714 (P<0.0001). Using single proportion test, the diagnostic percentage of osteoporosis was also significant difference (significant statistic) of between the DXA (11.2%) and QUS (20.4%) (Z=2.135, 0.028<P<0.03). By weighted kappa statistic of T-score, the diagnostic disagreement was found between QUS and DXA, the agreement was fair (kappa score =0.258, P<0.0001). QUS cannot replace DXA; it may be an alternative method for high-throughput screening tool for osteoporosis in health examination if it had been standardized as DXA. QUS is not recommended for diagnosis and monitoring of osteoporosis.
The aim of our study was to evaluate the difference and agreement between quantitative ultrasound (QUS) and dual X-ray absorptiometry (DXA) using statistical method, which is suitable for the health examination. Ninety-eight consecutive patients (female, 49±12 years old) of perimenopause were examined in this study. DXA of the lumbar spine was performed to acquire the BMD values and were expressed as T-score. At the same session, the calcaneus of the same patients was examined with QUS. Paired T-test and linear regression were performed to observe the relationship between QUS and DXA. The level of agreement was analyzed with weighted kappa (wk) statistics. The paired T-test for comparison of T-score of DXA and QUS showed t-value about 5.943 (P<0.001), which was statistical significance. Pearson's correlation coefficient for the comparison of QUS with DXA was R=0.714 (P<0.0001). Using single proportion test, the diagnostic percentage of osteoporosis was also significant difference (significant statistic) of between the DXA (11.2%) and QUS (20.4%) (Z=2.135, 0.028<P<0.03). By weighted kappa statistic of T-score, the diagnostic disagreement was found between QUS and DXA, the agreement was fair (kappa score =0.258, P<0.0001). QUS cannot replace DXA; it may be an alternative method for high-throughput screening tool for osteoporosis in health examination if it had been standardized as DXA. QUS is not recommended for diagnosis and monitoring of osteoporosis.
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