PMID- 25128036
OWN - NLM
STAT- MEDLINE
DCOM- 20150717
LR  - 20161125
IS  - 1878-4321 (Electronic)
IS  - 1049-3867 (Linking)
VI  - 24
IP  - 6
DP  - 2014 Nov-Dec
TI  - Use of FRAX as a determinant for risk-based osteoporosis screening may decrease 
      unnecessary testing while improving the odds of identifying treatment candidates.
PG  - 629-34
LID - S1049-3867(14)00082-6 [pii]
LID - 10.1016/j.whi.2014.06.006 [doi]
AB  - PURPOSE: We have assessed the hypothetical impact of guideline-concordant 
      osteoporosis screening on baseline behaviors utilizing two different guidelines 
      and determined the relative ability of each to identify osteoporosis treatment 
      candidates. METHODS: We conducted secondary analyses from the Fracture Risk 
      Perception Study, which enrolled patients aged 50 to 75 years to complete 
      questionnaires about their bone health. We determined our baseline screening 
      rates and detection of treatment candidates and then assessed the hypothetical 
      impact of adherence to U.S. Preventive Services Task Force (USPSTF) and National 
      Osteoporosis Foundation (NOF) criteria, particularly for women aged 50 to 64. 
      RESULTS: Of 144 women aged 50 to 64 years screened, 14 (9.7%) were treatment 
      candidates. Screening based on identification of one or more risks (NOF) would 
      lead to testing of 102 of the 144 patients (71%) to identify 12 of 14 treatment 
      candidates (86%). Applying USPSTF criteria (9.3% FRAX threshold) would test 45 of 
      the same 144 women (31%) to identify 11 of 14 treatment candidates (79%). NOF 
      risk-based criteria would result in a moderate absolute screening rate reduction 
      (16%, p = .0011; 95% CI, 7%-25%), but only marginal improvement in identifying 
      treatment candidates (odds ratio, 2.67; 95% CI, 0.57-12.47). Applying the more 
      selective USPSTF criteria greatly reduced unnecessary testing (56% absolute 
      screening rate reduction; p < .0001; 95% CI, 47%-64%) while further improving the 
      odds of identifying treatment candidates (odds ratio, 10.35; 95% CI, 2.72-39.35). 
      CONCLUSIONS: When contemplating screening younger patients, systematic 
      calculation of FRAX and ordering only when the 9.3% fracture risk threshold is 
      reached may decrease unnecessary screening for many women while still identifying 
      appropriate osteoporosis treatment candidates.
CI  - Copyright (c) 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. 
      All rights reserved.
FAU - Edwards, Frederick D
AU  - Edwards FD
AD  - Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona. Electronic 
      address: edwards.frederick@mayo.edu.
FAU - Grover, Michael L
AU  - Grover ML
AD  - Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona.
FAU - Cook, Curtiss B
AU  - Cook CB
AD  - Division of Endocrinology, Mayo Clinic, Scottsdale, Arizona; Division of 
      Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Scottsdale, 
      Arizona.
FAU - Chang, Yu-Hui H
AU  - Chang YH
AD  - Division of Biostatistics, Mayo Clinic, Scottsdale, Arizona.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140812
PL  - United States
TA  - Womens Health Issues
JT  - Women's health issues : official publication of the Jacobs Institute of Women's 
      Health
JID - 9101000
SB  - IM
MH  - Absorptiometry, Photon/*methods
MH  - Aged
MH  - Bone Density
MH  - Female
MH  - Guidelines as Topic
MH  - Humans
MH  - Mass Screening/*methods/standards
MH  - Middle Aged
MH  - Osteoporosis/*diagnostic imaging/epidemiology
MH  - Osteoporotic Fractures/*diagnostic imaging/epidemiology
MH  - Practice Guidelines as Topic
MH  - Predictive Value of Tests
MH  - Risk Assessment/*methods/standards
MH  - Risk Factors
MH  - Socioeconomic Factors
MH  - *Surveys and Questionnaires
MH  - World Health Organization
EDAT- 2014/08/17 06:00
MHDA- 2015/07/18 06:00
CRDT- 2014/08/17 06:00
PHST- 2014/01/16 00:00 [received]
PHST- 2014/06/12 00:00 [revised]
PHST- 2014/06/17 00:00 [accepted]
PHST- 2014/08/17 06:00 [entrez]
PHST- 2014/08/17 06:00 [pubmed]
PHST- 2015/07/18 06:00 [medline]
AID - S1049-3867(14)00082-6 [pii]
AID - 10.1016/j.whi.2014.06.006 [doi]
PST - ppublish
SO  - Womens Health Issues. 2014 Nov-Dec;24(6):629-34. doi: 10.1016/j.whi.2014.06.006. 
      Epub 2014 Aug 12.