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01-05-2016 | Original Article

A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men

Authors: J.-H. Lee, Y. K. Lee, S.-H. Oh, J. Ahn, Y. E. Lee, J. H. Pyo, Y. Y. Choi, D. Kim, S.-C. Bae, Y.-K. Sung, D.-Y. Kim

Published in: Osteoporosis International | Issue 5/2016

Abstract

Summary

This systematic review was performed to compare the diagnostic accuracy of vertebral fracture assessment (VFA) with that of spinal radiography for identification of vertebral fractures (VFs). VFA appeared to have moderate sensitivity and high specificity for detecting VFs when compared with spinal radiography.

Introduction

VFs are recognized as the hallmark of osteoporosis, and a previous VF increases the risk of a future fracture. Therefore, the timely detection of VFs is important for prevention of further fractures. This systematic review examined the diagnostic accuracy of VFA using dual X-ray absorptiometry (DXA) to identify VFs.

Methods

We searched for potentially relevant studies using electronic databases, including Ovid-Medline, Ovid-EMBASE, Cochrane library, and four Korean databases, from their inception to May 2013. We compared the diagnostic accuracy of VFA with that of spinal radiography for detection of VFs by analyzing the sensitivity and specificity using a 2 × 2 contingency table. Subgroup analyses were also performed on studies with a low risk of bias and applicability.

Results

Twelve studies were analyzed for the diagnostic accuracy of VFA. The sensitivity and specificity were 0.70–0.93 and 0.95–1.00, respectively, analyzed on a per-vertebra basis, and 0.65–1.00 and 0.74–1.00 on a per-patient basis. The sensitivity and specificity of five studies in subgroups with a low risk of bias in the intervention test were 0.70–0.84 and 0.96–0.99, respectively. In studies with a low risk of bias in the patient selection, those based on a per-vertebra basis in three studies were 0.70–0.93 and 0.96–1.00, respectively.

Conclusions

VFA had moderate sensitivity and high specificity for detecting VF when compared with spinal radiography. However, the present findings are insufficient to assess whether spinal radiography should be replaced by VFA.

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Title: A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men
Authors: J.-H. Lee
Y. K. Lee
S.-H. Oh
J. Ahn
Y. E. Lee
J. H. Pyo
Y. Y. Choi
D. Kim
S.-C. Bae
Y.-K. Sung
D.-Y. Kim
Publication date: 01-05-2016
Publisher: Springer London
Published in: Osteoporosis International / Issue 5/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-015-3436-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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