Validation of the male osteoporosis risk estimation score (MORES) in a primary care setting

Alvah R. Cass, Angela J. Shepherd

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Primary care physicians are positioned to promote early recognition and treatment of men at risk for osteoporosis-related fractures; however, efficient screening strategies are needed. This study was designed to validate the Male Osteoporosis Risk Estimation Score (MORES) for identifying men at increased risk of osteoporosis. Methods: This was a blinded analysis of the MORES, administered prospectively in a cross-sectional sample of men aged 60 years or older. Participants completed a research questionnaire at an outpatient visit and had a dual-energy X-ray absorptiometry (DXA) scan to assess bone density. Sensitivity, specificity, and area under-the-curve (AUC) were estimated for the MORES. Effectiveness was assessed by the number needed-to-screen (NNS) to prevent one additional major osteoporotic fracture. Results: A total of 346 men completed the study. The mean age was 70.2 ± 6.9 years; 76% were non- Hispanic white. Fifteen men (4.3%) had osteoporosis of the hip. The operating characteristics were sensitivity 0.80 (95% confidence interval [CI], 0.52- 0.96); specificity 0.70 (95% CI, 0.64-0.74), and AUC of 0.82 (95% CI, 0.71- 0.92). Screening with the MORES yielded a NNS to prevent one additional major osteoporotic fracture over 10 years with 259 (95% CI, 192-449) compared to 636 for universal screening with a DXA. Conclusion: This study validated the MORES as an effective and efficient approach to identifying men at increased risk of osteoporosis who may benefit from a diagnostic DXA scan. (J Am Board Fam Med 2013;26:436-444.).

Original languageEnglish (US)
Pages (from-to)436-444
Number of pages9
JournalJournal of the American Board of Family Medicine
Issue number4
StatePublished - Jul 2013
Externally publishedYes


  • Decision making
  • Men's health
  • Osteoporosis
  • Prevention
  • Primary health care
  • Screening

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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