Screening for Osteoporosis: An Update for the U.S. Preventive Services Task Force

Nelson, Heidi D; Haney, Elizabeth M; Dana, Tracy; Bougatsos, Christina; Chou, Roger

doi:10.7326/0003-4819-153-2-201007200-00262

Cited by 188 publications

(150 citation statements)

References 129 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…4 The United States Preventive Services Task Force (USPSTF) recommends dual-energy x-ray absorptiometry (DXA) screening for women aged 65 and older and for younger women who have a fracture risk greater than or equal to the risk of a 65 year old white female with no additional risk factors. 5 The National Osteoporosis Foundation has issued similar recommendations. 6 The extent to which clinicians adhere to USPSTF recommendations is unclear.…”

Section: Introductionmentioning

confidence: 99%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

View full text Add to dashboard Cite

BACKGROUND:The United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with dual-energy x-ray absorptiometry (DXA) for women aged ≥ 65 years and younger women with increased risk. BChoosing Wisely^initiatives advise avoiding DXA screening in women younger than 65 years without osteoporosis risk factors. OBJECTIVE: We aimed to determine the extent to which DXA screening is used in accordance with USPSTF recommendations within a regional health system. DESIGN: This was a retrospective longitudinal cohort study within 13 primary care clinics in the Sacramento, CA region. PATIENTS: The study included 50,995 women aged 40-85 years without prior osteoporosis screening, diagnosis, or treatment attending primary care visits from 2006 to 2012, observed for a mean of 4.4 years. MAIN MEASURES: We examined incidence of DXA screening. Covariates included age, race/ethnicity, and osteoporosis risk factors (body mass index<20, glucocorticoid use, secondary osteoporosis, prior high-risk facture, rheumatoid arthritis, alcohol abuse, and current smoking). KEY RESULTS: Among previously unscreened women for whom the USPSTF recommends screening, 7-year cumulative incidence of DXA screening was 58.8 % among women aged 60-64 years with ≥ 1 risk factor (95 % CI: 51.9-65.8 %), 57.8 % for women aged 65-74 years (95 % CI: 55.6-60.0 %), and 42.7 % for women aged ≥ 75 years (95 % CI: 38.7-46.7 %). Among women for whom the USPSTF does not recommend screening, 7-year cumulative incidence was 45.5 % among women aged 50-59 years (95 % CI 44.1-46.9 %) and 58.6 % among women aged 60-64 years without risk factors (95 % CI 55.9-61.4 %). CONCLUSIONS: DXA screening was underused in women at increased fracture risk, including women aged ≥ 65 years. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors. Interventions may be needed to augment the value of population screening for osteoporosis.

show abstract

Section: Introductionmentioning

confidence: 99%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…A Quantitative ultrasonography study indicated that no significant difference of BMD was found in an eight-year interval in a cohort consisting of healthy, older, postmenopausal women [105]. The revised and expanded recommendations in 2010 by the U.S. Preventive Services Task Force (USPSTF) underscore the need for more screening of the bone density [106]. The time interval of monitoring bone mineral density relies on both the precision error of the method used and the rate of bone loss for the population studied.…”

Section: Follow-up Time Using the Qctmentioning

confidence: 99%

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

et al. 2016

View full text Add to dashboard Cite

a b s t r a c t a r t i c l e i n f oOsteoporosis is a common metabolic bone disease, causing increased skeletal fragility characterized by a low bone mass and trabecular microarchitectural deterioration. Assessment of the bone mineral density (BMD) is the primary determinant of skeletal fragility. Computed tomography (CT)-based trabecular microarchitectural and mechanical assessments are important methods to evaluate the skeletal strength. In this review, we focus the feasibility of QCT BMD measurement using a calibration phantom or phantomless. The application of QCT could extend the bone mineral density assessment to all patients who underwent a heart, lung, whole-body, and as well as all routine clinical implications of CT scan.

show abstract

“…Since the menopause is a readily recognizable event, a number of analyses have been carried out where it has been used as a time when to start screening women for osteoporosis using BMD [15][16][17]. The cost of screening itself is not the dominant factor, because most treatments are more expensive (though this may vary between countries) and may have side effects.…”

Section: Screening At the Menopausementioning

confidence: 99%

EMAS position statement: Bone densitometry screening for osteoporosis

et al. 2011

View full text Add to dashboard Cite

Screening for Osteoporosis: An Update for the U.S. Preventive Services Task Force

Abstract: Agency for Healthcare Research and Quality.

Cited by 188 publications

References 129 publications

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

EMAS position statement: Bone densitometry screening for osteoporosis

Contact Info

Product

Resources

About