Simplifying screening for osteoporosis in Australian primary care

Abstract

The Prospective Screening for Osteoporosis; Australian Primary Care Evaluation of Clinical Tests tool will contribute to the diagnosis and management of osteoporosis by facilitating targeted screening and hence reducing the need for unnecessary radiology tests at the primary care level.

Comparison of plain vertebral X‐ray and dual‐energy X‐ray absorptiometry for the identification of older women for fracture prevention in primary care

“…This is consistent with the findings of Vilayphiou and others that women with vertebral fractures have poorer trabecular microarchitecture compared with women without vertebral fractures . Thus, without undertaking a plain X‐ray, most of the women with a vertebral fracture will be missed whether the T‐score is set at −3.0 as in this analysis or at −2.5, as we have previously shown …”

“…The Prospective Screening for Osteoporosis, Australian Primary Care Evaluation of Clinical Tests (PROSPECT) Study was a national study undertaken to develop an effective prescreening protocol to be used in primary care, facilitating targeted radiological investigation for osteoporosis in older community‐dwelling women . A national private radiology provider (I‐Med Australia) provided radiology services for the study.…”

“…The sample size calculation for the PROSPECT study was based on the development of the prescreening protocol for osteoporosis including an estimated prevalence of osteoporosis in the target population allowing for the clustering of recruitment around GP.…”

Screening for Osteoporosis Risk Among Community-Dwelling Older Adults: A Scoping Review

“…Nine screening tools examined a single self-reported or measured variable: age,31–33 body mass index (BMI),34,35 dairy intake,32,36 height change,32,37,38 hypertension,32 physical activity,39 race,33 secondhand smoke,40 and weight 31,41–44. Fifteen of the screening tools were standardized outcome measures that examined multiple variables: Age, Body Size, No Estrogen (ABONE),42,43 eFRAX/FRAX,34,43,45–48 Garvan Risk Fracture Calculator,43 Male Osteoporosis Risk Estimation Scores (MORES),49–51 National Osteoporosis Foundation,52 Osteoporosis Prescreening Risk Assessment (OPERA),53 ORAI,31,34,41–43,52,54–57 OSIRIS,43,57,58 OST,31,34,41,44–46,48,54,56,57,59–62 Osteoporosis Self-Assessment Tool for Asians (OSTA),42,43 OsteoRisk Index,63 SCORE,31,34,42,43,45,54–57,64–66 Self-Evaluating Risk Assessment Scale,67 SOF,66 and Three Factor Prospect 68. Four screening tools measured performance-based variables, including balance,35 grip strength,32,35,69–71 quadriceps strength,35 and walking speed,35 while a group of studies examined a combination of clinical risk factors 13,57,72–75…”

Screening for postmenopausal osteoporosis after 70 years of age

“…In recognition of the formidable obstacles to universal BMD testing in this age group, Davis et al, 23 reporting in this issue of Menopause, developed and validated a clinical case-finding instrument to help minimize the number of tests needed to identify a treatable case. Applying this strategy to a population of older women in an Australian primary care setting, 93% of all therapeutic candidates were identified while avoiding imaging in 14% of the population.…”