Comparative Effectiveness and Cost-Effectiveness of Strategies to Screen for Osteoporosis in Postmenopausal Women
Authors: John T. Schousboe, Margaret L. Gourlay
Journal: Annals of Internal Medicine (2011)

Editorials6 December 2011Comparative Effectiveness and Cost-Effectiveness of Strategies to Screen for Osteoporosis in Postmenopausal WomenJohn T. Schousboe, MD, PhD and Margaret L. Gourlay, MD, MPHJohn T. Schousboe, MD, PhDFrom Park Nicollet Institute for Research & Education, Park Nicollet Health Services, and University of Minnesota, Minneapolis, MN 55416, and University of North Carolina, Chapel Hill, NC 26599.Search for more papers by this author and Margaret L. Gourlay, MD, MPHFrom Park Nicollet Institute for Research & Education, Park Nicollet Health Services, and University of Minnesota, Minneapolis, MN 55416, and University of North Carolina, Chapel Hill, NC 26599.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-11-201112060-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Everything should be made as simple as possible, but not simpler.—Albert EinsteinThe U.S. Preventive Services Task Force recommends screening for osteoporosis in women aged 65 years or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors (1). However, screening recommendations lack evidence-based guidance about screening intervals and when screening should cease (1, 2). Furthermore, screening in younger postmenopausal women is left to the discretion of the clinician, with osteoporosis (3–5) and fracture (6, 7) risk assessment tools as a guide. Although the ...References1. U.S. Preventive Services Task Force. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med. 2011;154:356-64. [PMID: 21242341] LinkGoogle Scholar2. Leslie WD, Schousboe JT. A review of osteoporosis diagnosis and treatment options in new and recently updated guidelines on case finding around the world. Curr Osteoporos Rep. 2011;9:129-40. [PMID: 21655931] CrossrefMedlineGoogle Scholar3. Cadarette SM, Jaglal SB, Murray TM, McIsaac WJ, Joseph L, Brown JP; Canadian Multicentre Osteoporosis Study. Evaluation of decision rules for referring women for bone densitometry by dual-energy x-ray absorptiometry. JAMA. 2001;286:57-63. [PMID: 11434827] CrossrefMedlineGoogle Scholar4. 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[PMID: 10210242] CrossrefMedlineGoogle Scholar13. Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302:1573-9. [PMID: 19826027] CrossrefMedlineGoogle Scholar14. Melton LJ, Kearns AE, Atkinson EJ, Bolander ME, Achenbach SJ, Huddleston JM, et al. Secular trends in hip fracture incidence and recurrence. Osteoporos Int. 2009;20:687-94. [PMID: 18797813] CrossrefMedlineGoogle Scholar15. Koh LK, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, et al; Osteoporosis Self-Assessment Tool for Asians (OSTA) Research Group. A simple tool to identify asian women at increased risk of osteoporosis. Osteoporos Int. 2001;12:699-705. [PMID: 11580084] CrossrefMedlineGoogle Scholar16. Cadarette SM, Jaglal SB, Murray TM, McIsaac WJ, Joseph L, Brown JP; Canadian Multicentre Osteoporosis Study. Evaluation of decision rules for referring women for bone densitometry by dual-energy x-ray absorptiometry. JAMA. 2001;286:57-63. [PMID: 11434827] CrossrefMedlineGoogle Scholar17. Gourlay ML, Miller WC, Richy F, Garrett JM, Hanson LC, Reginster JY. Performance of osteoporosis risk assessment tools in postmenopausal women aged 45-64 years. Osteoporos Int. 2005;16:921-7. [PMID: 16028108] CrossrefMedlineGoogle Scholar18. Curtis JR, Carbone L, Cheng H, Hayes B, Laster A, Matthews R, et al. Longitudinal trends in use of bone mass measurement among older Americans, 1999-2005. J Bone Miner Res. 2008;23:1061-7. [PMID: 18302495] CrossrefMedlineGoogle Scholar19. Curtis JR, Laster A, Becker DJ, Carbone L, Gary LC, Kilgore ML, et al. The geographic availability and associated utilization of dual-energy X-ray absorptiometry (DXA) testing among older persons in the United States. Osteoporos Int. 2009;20:1553-61. [PMID: 19107383] CrossrefMedlineGoogle Scholar20. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22:465-75. [PMID: 17144789] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John T. Schousboe, MD, PhD; Margaret L. Gourlay, MD, MPHAffiliations: From Park Nicollet Institute for Research & Education, Park Nicollet Health Services, and University of Minnesota, Minneapolis, MN 55416, and University of North Carolina, Chapel Hill, NC 26599.Disclaimer: The content of this editorial is solely the responsibility of the authors and does not necessarily reflect the official views of the funding agencies.Grant Support: Dr. Schousboe is supported by the National Institutes of Health (Public Health Service research grant 1R01 AG038415-01). Dr. Gourlay is supported by the National Center for Research Resources (grant K23RR024685).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2481.Corresponding Author: John T. Schousboe, MD, PhD, Park Nicollet Institute, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416; e-mail, john.[email protected]com.Current Author Addresses: Dr. Schousboe: Park Nicollet Institute, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416.Dr. Gourlay: Department of Family Medicine, University of North Carolina, Manning Drive, CB 7595, Chapel Hill, NC 27599-7595. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Different Screening Strategies for Osteoporosis in Postmenopausal Women Smita Nayak , Mark S. Roberts , and Susan L. Greenspan Metrics Cited byBone Density Screening and Re-screening in Postmenopausal Women and Older MenTECHNIQUES FOR DIAGNOSING OSTEOPOROSIS: A SYSTEMATIC REVIEW OF COST-EFFECTIVENESS STUDIESRisk factors and management of osteoporosis in inflammatory bowel diseaseClinical Use of Bone Densitometry 6 December 2011Volume 155, Issue 11Page: 788-789KeywordsBoneBone mineral densityDensitometryDual energy x ray absorptiometryOsteoporosisPhoton absorptiometryPrimary care physiciansRisk assessmentsRisk managementUltrasound imaging ePublished: 6 December 2011 Issue Published: 6 December 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...