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Titolo:
Peripheral or central densitometry: Does it matter which technique we use?
Autore:
Blake, GM; Fogelman, I;
Indirizzi:
Guys Hosp, Dept Nucl Med, London SE1 9RT, England Guys Hosp London England SE1 9RT Dept Nucl Med, London SE1 9RT, England
Titolo Testata:
JOURNAL OF CLINICAL DENSITOMETRY
fascicolo: 2, volume: 4, anno: 2001,
pagine: 83 - 96
SICI:
1094-6950(200122)4:2<83:POCDDI>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MINERAL DENSITY; X-RAY ABSORPTIOMETRY; BAND ULTRASOUND ATTENUATION; VERTEBRAL FRACTURE RISK; ELDERLY WOMEN; POSTMENOPAUSAL OSTEOPOROSIS; RANDOMIZED TRIAL; HIP-FRACTURES; PREDICTION; DIAGNOSIS;
Keywords:
dual X-ray absorptiometry; fracture risk; peripheral measurements;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Blake, GM Guys Hosp, Dept Nucl Med, St Thomas St, London SE1 9RT, England Guys Hosp St Thomas St London England SE1 9RT SE1 9RT, England
Citazione:
G.M. Blake e I. Fogelman, "Peripheral or central densitometry: Does it matter which technique we use?", J CLIN DENS, 4(2), 2001, pp. 83-96

Abstract

Over the past decade, bone density scans have assumed an essential role inthe diagnosis of osteoporosis. Although dual X-ray absorptiometry (DXA) scans of the central skeleton remain widely used, a variety of different types of equipment for measuring peripheral sites is now available. However, the poor correlation between different types of measurement and a lack of consensus on how results from peripheral sites should be interpreted have proved a barrier to the more widespread use of these devices. These issues prompt the following questions: Which technique best identifies patients at risk of fracture? What approaches to scan interpretation ensure the closest agreement among different methods? Does it matter if different patients are selected for treatment on the basis of different techniques? The relative risk (RR) of fracture derived from prospective studies is a key parameter forcomparing the clinical value of different techniques. Recent reports confirm the advantages of hip bone mineral density compared with peripheral measurements for predicting hip fracture risk, although for fractures at other sites the differences are inconclusive. Using receiver operating characteristic curves, we show that the guidelines adopted for scan interpretation are of crucial importance for ensuring that the information provided is used effectively. The closest agreement among different techniques is achieved by setting thresholds for peripheral devices that target either the same percentage of the population or the same percentage of future fracture cases as femur DXA. Different methods select different groups of individuals from the total pool of patients who will later sustain a fracture, with the mostsuccessful technique being the one with the largest RR value. The emphasisplaced by many studies on validating new techniques by studying their correlation with DXA may lead to the clinical value of peripheral devices beingunderestimated when the key datum is the RR value inferred from prospective fracture studies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/08/20 alle ore 23:14:09