Application of a Triage Approach to Peripheral Bone Densitometry Reduces the Requirement for Central DXA but is not Cost Effective

摘要: A method proffered for the interpretation of measurements from peripheral dual energy X-ray absorptiometry (pDXA) is a triage approach to stratify patients into one three risk categories; (i) high-treat, (ii) medium-refer central DXA and (iii) low-reassure. The aim this study was apply measures scanners indices categories (i), or (iii). 207 post-menopausal women had which they were categorised as non-osteoporotic osteoporotic. Additional scans left calcaneus performed on (GE Lunar Achilles PIXI, McCue CubaClinical). From demographic details four calculated algorithms combining index obtained. All measures, combination good at identifying osteoporosis (ROC areas: 0.67-0.82). Each tool stratified varying numbers osteoporotic each category using approach. One algorithm (PIXI & (OSIRIS)) best by minimising misclassification (10% non-osteoporotic, 10% osteoporotic) reducing requirement 36%. However cost implementing PIXI OSIRIS greater (263%) than (100%) scanning all women. Although an effective unnecessary treatment in high make it impractical. Therefore alternative more cost-effective has been suggested.