Osteoporosis Risk Assessment Index (ORAI) Calculator

Osteoporosis Risk Assessment Index (ORAI) Calculator for Endocrinology. ORAI is a low-bone-density prescreening instrument, not a personal fracture-probability calculator. The 2025 USPSTF recommendation supports screening women aged 65 or older and at-risk younger postmenopausal women; a low total does not veto those indications.

For shared guidance on choosing a tool and documenting results, read the clinical calculator workflow.

How this calculator works

This version interprets a completed ORAI total; it does not reproduce the questionnaire. It accepts attainable whole-number totals from 0 to 26 and compares them with the commonly used cutoff of 9. Impossible totals are rejected rather than silently rounded.

When to use this calculator

Use after completing the authorized ORAI assessment in the appropriate adult-women context. Confirm that the recorded total is ORAI rather than OST, SCORE or a fracture index. A current assessment should consider the person's screening indications independently.

Inputs used

  • Finalized ORAI total from the source worksheet

Clinical interpretation

ORAI is a low-bone-density prescreening instrument, not a personal fracture-probability calculator. The 2025 USPSTF recommendation supports screening women aged 65 or older and at-risk younger postmenopausal women; a low total does not veto those indications.

Worked example

A finalized total of 8 is below the commonly used cutoff; 9 is at the cutoff. A total of 26 is accepted. A total of 1 or a fractional total is rejected because it cannot arise from the source point combinations.

Limitations and safety notes

No raw questionnaire scoring, BMD diagnosis or medication recommendation is supplied. Validating a total's arithmetic range does not establish that the original form was completed correctly. The historical population and estrogen-exposure variable limit transfer to other settings.

Frequently asked questions

Can this replace the original form?

No. It requires the finalized result from that form and supplies an original explanation of the total.

Does 9 mean a 9% fracture risk?

No. Nine is a point threshold, not a probability or a time horizon.

References

  • Original Cadarette ORAI derivation identity and low-BMD screening purpose. https://pubmed.ncbi.nlm.nih.gov/10813010/
  • 2025 recommendation and ORAI table: attainable point totals and >=9 threshold; women >=65 screening independent of a low score. https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/osteoporosis-screening

Editorial review and citation methodology

Maintained by the Quick Medical Calculator Editorial Team. Content record date: September 9, 2026. A content date is not evidence of independent clinical review. Individual clinical sign-off is not recorded on this page.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

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