Abstract
A Summary A pilot study on the use of P-EU to identify patients without osteoporosis and/or a subclinical vertebral fracture after a recently sustained non-vertebral fracture (NVF).Introduction Screening with portable devices at emergency departments or plaster rooms could be of interest to limit referrals for dual X-ray absorptiometry (DXA) and vertebral fracture assessment (VFA). We calculated the number of negative tests for osteoporosis and/or subclinical vertebral fractures (VFs) using pulse-echo ultrasonometry (P-UE) at different thresholds.Patients and methods In this cross-sectional study, 209 consecutive women of 50-70 years with a recent non-vertebral fracture (NVF) were studied at the Fracture Liaison Service (FLS) of one hospital. All women received DXA/VFA and P-EU (Bindex (R)) assessments. Various P-EU thresholds (based on the density index (DI, g/cm(2))) were analyzed to calculate the best balance between true negative (indeed no osteoporosis and/or subclinical VF) and false negative tests (osteoporosis and/or subclinical VF according to DXA/VFA).Results Eighty-three women had osteoporosis (40%) and 17 women at least one VF (8%). Applying the manufacturer's recommended P-EU threshold (DI 0.844 g/cm(2)) being their proposed cut-off for not having hip osteoporosis resulted in 77 negative tests (37%, 31% true negative and 6% false negative tests). A DI of 0.896 g/cm(2) resulted in 40 negative tests (19.3%) (38 true negative (18.3%) and 2 false negative tests (1.0%)).Conclusion The application of P-EU enables the identification of a substantial proportion of women with recent non-vertebral fractures at the FLS who would not need a DXA/VFA referral because they had no osteoporosis and/or subclinical vertebral fractures. The most conservative P-EU threshold resulted in 18.3% true negative tests verified by DXA/VFA against 1% false negative test results.
Original language | English |
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Article number | 56 |
Number of pages | 9 |
Journal | Archives of Osteoporosis |
Volume | 15 |
Issue number | 1 |
DOIs | |
Publication status | Published - 14 Apr 2020 |
Keywords
- density
- diagnosis
- dxa/vfa
- elderly-women
- fls
- implementation
- liaison service
- management
- non-vertebral fracture
- osteoporosis
- practice framework
- prevention
- pulse-echo ultrasound
- risk
- subclinical vertebral fracture
- x-ray
- Subclinical vertebral fracture
- FLS
- LIAISON SERVICE
- DENSITY
- Osteoporosis
- DXA/VFA
- DIAGNOSIS
- MANAGEMENT
- Non-vertebral fracture
- PREVENTION
- IMPLEMENTATION
- ELDERLY-WOMEN
- RISK
- PRACTICE FRAMEWORK
- X-RAY
- Pulse-echo ultrasound