Authors' objectives: This report has been prepared to provide information to the provincial Clinical Practice Guidelines Program and to assist debate on the appropriate use of BDM in routine health care services.

Authors' recommendations: Guidelines for use of bone density measurement (BDM) in the management of osteoporosis in women should take account of the following issues: Whether the clinical target is maintenance of bone health or prevention of fractures. The clinical significance of both vertebral fracture and hip fracture. The substantial uncertainty in correctly classifying an individual as osteoporotic on the basis of her bone mineral density alone. Follow-up BDM at short time intervals will not provide a reliable measurement of changes in bone density. The minimum acceptable interval between measurements may be as long as two years. Available evidence does not support population screening using BDM. However, BDM provides a guide to bone health and risk of fracture. There is potential for selective use of BDM in association with appraisal of other clinical risk factors. Assessment protocols for such an approach have promise as a useful tool for selecting whom to test. Advice on treatment options should consider evidence of efficacy and effectiveness in terms of absolute reduction in risk of fracture, long term compliance and adverse effects. There is scope for the introduction of decision aids and other approaches to providing clients with information on benefits and risks of interventions. Additional information is required on the performance of newer types of BDM devices such as peripheral DXA. BDM services require excellent quality assurance. Reporting of BDM results should be factual. Recommendations for treatment should be avoided, unless the clinical history is available.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 1999

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: Alberta Heritage Foundation for Medical Research