ACR Appropriateness Criteria Osteoporosis and Bone Mineral Density EVIDENCE TABLE

ACR Appropriateness Criteria® Osteoporosis and Bone Mineral Density EVIDENCE TABLE Reference 1. NIH Consensus Development Panel on Osteoporosis Preve...
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ACR Appropriateness Criteria® Osteoporosis and Bone Mineral Density EVIDENCE TABLE Reference 1.

NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis and Therapy. Osteoporosis Prevention, Diagnosis, and Therapy. JAMA. 2001;285(6):785-795.

* See Last Page for Key

Study Type Review/OtherDx

Patients/ Events 13 member panel

Study Objective (Purpose of Study) To clarify the factors associated with prevention, diagnosis, and treatment of osteoporosis, and to present the most recent information available in these areas.

2016 Review

Study Results Though prevalent in white postmenopausal women, osteoporosis occurs in all populations and at all ages and has significant physical, psychosocial, and financial consequences. Risks for osteoporosis (reflected by low BMD) and for fracture overlap but are not identical. More attention should be paid to skeletal health in persons with conditions associated with secondary osteoporosis. Clinical risk factors have an important but poorly validated role in determining who should have BMD measurement, in assessing fracture risk, and in determining who should be treated. Adequate calcium and vitamin D intake is crucial to develop optimal peak bone mass and to preserve bone mass throughout life. Supplementation with these 2 nutrients may be necessary in persons not achieving recommended dietary intake. Gonadal steroids are important determinants of peak and lifetime bone mass in men, women, and children. Regular exercise, especially resistance and high-impact activities, contributes to development of high peak bone mass and may reduce risk of falls in older persons. Assessment of bone mass, identification of fracture risk, and determination of who should be treated are the optimal goals when evaluating patients for osteoporosis. Fracture prevention is the primary treatment goal for patients with osteoporosis. Several treatments have been shown to reduce the risk of osteoporotic fractures, including those that enhance bone mass and reduce the risk or consequences of falls. Adults with vertebral, rib, hip or distal forearm fractures should be evaluated for osteoporosis and given appropriate therapy.

Study Quality 4

Ward Page 1

ACR Appropriateness Criteria® Osteoporosis and Bone Mineral Density EVIDENCE TABLE Reference 2.

3.

4.

5.

Patients/ Events N/A

Study Objective (Purpose of Study) A report on bone health and osteoporosis.

Review/OtherDx

N/A

To provide an update of annual economic costs imposed by fall injuries.

No results stated in abstract.

4

The article provides (a) a brief review of the current X-ray methods used for quantitative assessment of the skeleton, (b) data on the levels of radiation exposure associated with these methods and (c) information about radiation safety issues. To determine the best measurement for predicting hip fractures, the authors assessed bone density of the hip, spine, radius, and calcaneus in a cohort of older women, and followed them for the occurrence of hip fractures.

No results stated.

4

65 women had hip fractures during a mean follow-up of 1.8 years. Each SD decrease in femoral neck bone density increased the ageadjusted risk of hip fracture 2.6 times (95% CL 1.9, 3.6). Women with bone density in the lowest quartile had an 8.5-fold greater risk of hip fracture than those in the highest quartile. Bone density of the femoral neck was a better predictor than measurements of the spine (P

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