Comparison of accuracy and cost effectiveness of clinical criteria and BUA for referral for BMD assessment by DXA in osteoporotic and osteopenic perimenopausal subjects

摘要: A pilot study of 107 women aged 60-69 years recently suggested that the measurement broadband ultrasound attenuation (BUA) provides a superior cost effective pre-screen referral method for bone mineral density (BMD) by DXA (dual-energy X-ray absorptiometry) than can be achieved clinical criteria (CC). The aim this was to compare accuracy and effectiveness BUA in younger cohort. 599 50-54 (52.18 \pm 1.35) had previously been measured at lumbar spine right femoral neck, along with calcaneus. Each subject also completed an extensive social questionnaire ascertain those who would have met one or more six general adopted our Centre. classified using WHO as normal, osteopenic osteoporotic, defined neck. Sensitivity, specificity were calculated criteria, noting analysis undertaken without oestrogen deficiency criterion (CC1)c "Any deficient woman want treated continue treatment if found osteoporotic". identifying osteoporotic subjects 72.8% (at point matched sensitivity specificity, 75 dB MHz^{-1}), 30.7% CC(1-6) 64.3% CC(2-6). When incorporated, accuracies 63.8% 82 60.3% 55.7% minimum per correctly identified £573.50 alone, £325 BUA, £458 £416 costs £87, £83.50, £78 £74, respectively. overall cost, dependent upon prevalence osteoporosis (or osteopenia) within population, accurately indicates feasibility population-based screening programme. For identification either from population DXA, prevalence-compensated (cost multiplied prevalence) is £45, irrespective age If CC(2-6) £32 £42 cohorts, falls £25 £43 cohort, both (£38) (£43) perform similarly alone. BUA appears provide valuable subjects, less so osteopenic. It are management incorporating then neither nor satisfactory methods. An unanswered question study, however, whether has independent role assessment fracture risk perimenopausal do not benefit DXA.