Diagnostic performance and costeffectiveness of technologies to measure bone mineral density in postmenopausal women
Dunfield L, Mierzwinski-Urban M, Hodgson A, Banks R
Record ID 32008000043
English, French
Authors' objectives:
"Research Questions 1. What is the diagnostic performance of the technologies used to measure BMD (i.e., peripheral densitometry, quantitative computed tomography, quantitative ultrasonography, radiography absorptiometry) compared to dual-energy xray absorptiometry when used to evaluate the risk of osteoporotic fracture in postmenopausal women? 2. What are the comparative economic considerations relative to the use of the different technologies to measure BMD?" (executive summary)
Authors' recommendations:
The AUC for DXA ranged from 0.59 to 0.95 for the different bones analyzed in the different studies. QUS AUC ranged from 0.60 to 0.93, and QCT AUC ranged from 0.87 to 0.93 in the studies. There do not seem to be major differences between DXA and QUS in the studies. ORs for discriminating fractures were reported for four of the six studies and ranged from 1.35 to 4.8 for DXA, 1.26 to 4.18 for QUS, and 12.7 to 16 for QCT. There were no major differences between the ORs in the studies, except in the study on MDCT and DXA where the OR was higher for MDCT compared to DXA.
The costs for DXA and QUS were similar in two cost studies. It is unknown, however, whether any of these studies could be translatable to a Canadian setting.
QCT seems to be at least as effective as DXA. QCT, however, uses more radiation than DXA. Overall, QUS seems to be comparable to DXA for discriminating fractures in postmenopausal women, although this is based on low quality evidence. Other factors such as the lack of radiation used for QUS and the limited availability of DXA may help to determine which screening test would be most useful. None of these were Canadian studies and more research is needed on the methods to measure BMD in postmenopausal women.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Bone Density
- Costs and Cost Analysis
- Diagnosis
- Menopause
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health (CADTH)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.