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Performance of clinical prediction models for identifying postmenopausal osteoporosis: a systematic review and meta-analysis

Huang X, Gan Y, Guo X, Li Y, Wang L, Qin J, Sun C, Yin Y et al.

BMC musculoskeletal disorders, 2026

45,383 participants · 1 citation

Abstract

Purpose: Early clinical recognition of postmenopausal osteoporosis (PMOP) can be challenging. With the advancement of machine learning, several prediction models for PMOP have been developed. This study assessed their performance by carrying out a systematic review and meta-analysis.

Methods: The PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang database and China Science and Technology Journal Database (VIP) were systematically searched. Studies with a sample size of at least 100 and involving postmenopausal women were included Included models were descriptively summarized, and meta-analyses were conducted to derive discrimination estimates. Homogeneous results from different studies were pooled using MedCalc software.

Results: Out of 37,115 identified studies, 21 were included. Most of the models were developed using data from cross-sectional studies and the sample size of included models ranged from 103 to 12,175, totaling 45,383 participants with 16,008 positive events. Several models contained some similar predictors, including age, prior fractures, and body mass index (BMI). We also conducted a meta-analysis that included 22 models with reported AUC and its 95% confidence interval (95% CI), which demonstrated that the prediction models have good discriminative performance. The most frequently observed predictive variables include age, weight, body mass index (BMI), menopause status, height, fracture history, lower…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 45,383 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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