en Rheumatology Rheumatology Original Research Original Research <p> <strong> Background </strong>:SCORE, OST and ORAI risk assessment tools could reduce the cost burden of BMD tests by selecting the high risk patients to osteoporosis. In this study we compared the ability of these risk assessment measures to assess probability of the osteoporosis among post-menopausal women. </p><p> <strong> Methods </strong>: 211 post-menopausal women aged 45-88 years enrolled into the study. All of the patients underwent BMD test and divided into two groups according to T-Score level. 43 patients (20.4%) had T-Score ≤-2.5 (osteoporotic) (group-1) and 168 (70.6%) patients had T-Score of > -2.5 (non-osteoporotic). Among 168 non-osteoporotic cases, 88 had -2.5≤T-Score≤-2 in at least one bony area. These 88 cases in addition to the 43 cases with -2.5≤T-Score considered as high risk group to osteoporosis (group 2). Afterward, SCORE, OST and ORAI risk scores were calculated and sensitivity, specificity, likelihood ratio, accuracy index and area under the curve of each tool were determined in both groups and then compared with each other. </p><p> <strong> Results </strong>: SCORE had the highest sensitivity compared with others in both groups (95% and 88.2% respectively). Moreover, it had the highest diagnostic odds ratio and negative predictive value between the three methods. OST had the highest likelihood ratio and specificity in both groups (71.4% and 75.4%). There was significant difference between the sensitivity and specificity of the tests (p= 0.004 and 0.027). </p><p> <strong> Conclusion </strong>: OST with the highest specificity and positive LR had a special role in determining the osteoporotic patients and SCORE with the highest sensitivity and negative predictive value had an exceptional role in exclusion of the non- osteoporotic individuals. However, considering the area under the curve, there was no significant difference among these three methods in determining osteoporosis. </p> Osteoporosis, Bone density, Risk assessment, Sensitivity, Specificity, Predictive value. 604 609 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-726&slc_lang=en&sid=1 Arman Ahmadzadeh armanahmadzadeh@gmail.com 200319475328460013256 200319475328460013256 No Rheumatology Department, Loghman Hakim hospital, ShaheedBeheshti University of Medical Sciences (SBUMC), Tehran, Iran. Mohammadmehdi Emam mmemam@yahoo.com 200319475328460013257 200319475328460013257 No Rheumatology Department, Loghman Hakim hospital, Shaheed Beheshti University of Medical Sciences (SBUMC), Tehran, Iran. Alireza Rajaei arrajaei@gmail.com 200319475328460013258 200319475328460013258 Yes Rheumatology Department, Loghman Hakim hospital, Shaheed Beheshti University of Medical Sciences (SBUMC), Tehran, Iran. Mohammad Moslemizadeh M_Moslemizadeh@yahoo.com 200319475328460013259 200319475328460013259 No Rheumatology Department, Loghman Hakim hospital, Shaheed Beheshti University of Medical Sciences (SBUMC), Tehran, Iran. Maryam Jalessi jalessimd@gmail.com 200319475328460013260 200319475328460013260 No Endoscopic Pituitary and Skull Base Surgery Unit, ENT-Head and Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.