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Osteoporosis International
Published in: Osteoporosis International 7/2006

01-07-2006 | Short Communication

An audit of bone densitometry practice with reference to ISCD, IOF and NOF guidelines

Authors: R. Baddoura, H. Awada, J. Okais, M. Salamoun, G. Ayoub, N. Ziadé, G. El Hajj-Fuleihan

Published in: Osteoporosis International | Issue 7/2006

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Abstract

Introduction

The impact of osteoporosis guidelines on clinical practice has not been fully evaluated.

Objectives

To estimate the positive predictive value (PPV) of the National Osteoporosis Foundation (NOF), the International Osteoporosis Foundation (IOF) and the International Society for Clinical Densitometry (ISCD) guidelines for osteoporosis and compare it to the PPV of clinical judgement alone.

Methods

All subjects tested for bone mineral density during the fall of 2001 in three teaching hospitals in Beirut were invited to participate. The reference databases used for the calculation of the T-score were the NHANES database for the hip and the manufacturer’s database for the spine. The impact of using guidelines was measured by the increment in PPV. Osteoporosis was defined as a T-score ≤−2.5 at either the spine or hip.

Results

A total of 307 post-menopausal women were tested with dual-energy X-ray absorptiometry (DXA). In current practice (clinical judgement alone), the PPV for osteoporosis was 42.4%; using NOF guidelines, 236 women would have been tested, and the PPV would have been 46.2%. Similarly, using IOF or ISCD guidelines, 236 women would have been tested, and the PPV would have been 47.1%.

Conclusion

Compared to current clinical practice, application of the ISCD, IOF and NOF guidelines may increase the predictive value of a central DXA for osteoporosis.
Literature
1.
Khaltaev NG (1996) Osteoporosis as a growing problem: WHO perspectives. Scand J Rheumatol Suppl 103:129–133PubMed
2.
Reginster JL (1996) Harmonization of clinical practice guidelines for the prevention and treatment of osteoporosis and osteopenia in Europe: a difficult challenge. Calcif Tissue Int 59[Suppl 1]:S24–S29PubMedCrossRef
3.
Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34(1):195–202 JanPubMedCrossRef
4.
Taylor BC, Schreiner PJ, Stone KL, Fink HA, Cummings SR, Nevitt MC, Bowman PJ, Ensrud KE (2004) Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc 52(9):1479–1486 SepPubMedCrossRef
5.
Albrand G, Munoz F, Sornay-Rendu E, DuBoeuf F, Delmas PD (2003) Independent predictors of all osteoporosis-related fractures in healthy post-menopausal women: the OFELY study. Bone 32(1):78–85PubMedCrossRef
6.
Kanis JA, Johnell O, Oden A, De Laet C, Jonsson B, Dawson A (2002) Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30(1):251–258 JanPubMedCrossRef
7.
Nguyen TV, Center JR, Pocock NA, Eisman JA (2004) Limited utility of clinical indices for the prediction of symptomatic fracture risk in post-menopausal women. Osteoporos Int 15:49–55 JanPubMedCrossRef
8.
Goemaere S, Zegels B, Toye K, Cremer S, Demuynck R, Daems M, Dobbelaere K, Sedrine WB, Albert A, Dewe W, Kaufman JM, Reginster JY (1999) Limited clinical utility of a self-evaluating risk assessment scale for post-menopausal osteoporosis: lack of predictive value of lifestyle-related factors. Calcif Tissue Int 65(5):354–358 NovPubMedCrossRef
9.
Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD (1993) Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporos Int 3(3):120–126 MayPubMedCrossRef
10.
Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27(5):585–590 NovPubMedCrossRef
11.
Solomon DH, Brookhart MA, Gandhi TK, Karson A, Gharib S, Orav EJ, Shaykevich S, Licari A, Cabral D, Bates DW (2004) Adherence with osteoporosis practice guidelines: a multilevel analysis of patient, physician, and practice setting characteristics. Am J Med 117(12):919–924 Dec 15PubMedCrossRef
12.
Wei GS, Jackson JL, O’Malley PG (2003) post-menopausal osteoporosis risk management in primary care: how well does it adhere to national practice guidelines? J Am Med Womens Assoc 58(2):99–104 SpringPubMed
13.
Castel H, Bonneh DY, Sherf M, Liel Y (2001) Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low-impact fractures. Osteoporos Int 12(7):559–564PubMedCrossRef
14.
Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D (1997) Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 7(4):390–406PubMedCrossRef
15.
Kanis JA, Geusens P, Christiansen C (1991) Guidelines for clinical trials in osteoporosis. A position paper of the European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 1(3):182–188 JunPubMedCrossRef
16.
Baran DT, Faulkner KG, Genant HK, Miller PD, Pacifici R (1997) Diagnosis and management of osteoporosis: guidelines for the utilization of bone densitometry. Calcif Tissue Int 61(6):433–440 DecPubMedCrossRef
17.
National Osteoporosis Foundation (1998) Osteoporos Int 1998[Suppl 14]:S7–S80
18.
Leib ES, Lewiecki EM, Binkley N, Hamdy RC, International Society for Clinical Densitometry (2004) Official positions of the International Society for Clinical Densitometry. J Clin Densitom 7:1–5PubMedCrossRef
19.
Kanis JA, Black D, Cooper C, Dargent P, Dawson-Hughes B, De Laet C, Delmas P, Eisman J, Johnell O, Jonsson B, Melton L, Oden A, Papapoulos S, Pols H, Rizzoli R, Silman A, Tenenhouse A, International Osteoporosis Foundation, National Osteoporosis Foundation (2002) A new approach to the development of assessment guidelines for osteoporosis. Osteoporos Int 13(7):527–536 JulPubMedCrossRef
20.
Kanis JA, Torgerson D, Cooper C (2000) Comparison of the European and USA practice guidelines for Osteoporosis. Trends Endocrinol Metab 11(1):28–32 Jan–FebPubMedCrossRef
Metadata
Title
An audit of bone densitometry practice with reference to ISCD, IOF and NOF guidelines
Authors
R. Baddoura
H. Awada
J. Okais
M. Salamoun
G. Ayoub
N. Ziadé
G. El Hajj-Fuleihan
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 7/2006
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0101-6

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