BoneKEy Reports | BoneKEy Watch
Osteoporosis screening in postmenopausal women: how and when?
DOI:10.1038/bonekey.2012.73
Bone fractures related to osteoporosis carry a high personal cost and put a large financial burden on healthcare providers. Treating at-risk postmenopausal women with bisphosphonates is cost effective; this study used modeling to investigate which methods of screening could best identify women who need treatment, and the optimal timing of screening tests.
The authors found that bone mineral density (BMD) screening was cost-effective when started in women aged 55, 10 years earlier than most current guidelines recommend. The data suggest continuing testing until the age of 80. Of the screening tests available, several were found to be cost-effective either when used alone, or in combination. These included central dual-energy X-ray absorptiometry (DXA) screening, calcaneal quantitative ultrasound (QUS) and use of the SCORE prescreening tool.
According to the evidence from their model, Nayak et al. recommend DXA screening, treating women with a T-score of <−2.5 and then repeat screening at 5-year intervals. For women who do not have easy access to DXA screening, combined use of SCORE and QUS provides a workable alternative.
Editor's comment: This is useful information about how best to monitor postmenopausal women who do not meet the criteria for treatment at the time of their first evaluation. Individualizing the monitoring strategy and testing interval would improve the cost-effectiveness.
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