Screening for postmenopausal osteoporosis
CONCLUSIONS: Although there is no direct evidence that screening prevents fractures, there is evidence that the prevalences of osteoporosis and fractures increase with age, that the short-term risk of fracture can be estimated by bone measurement tests and risk factor assessment, and that treatment...
| Main Authors: | , |
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| Corporate Authors: | , |
| Format: | eBook |
| Language: | English |
| Published: |
Rockville (MD)
Agency for Healthcare Research and Quality (US)
2002, 2002
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| Series: | Systematic evidence reviews
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| Subjects: | |
| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | CONCLUSIONS: Although there is no direct evidence that screening prevents fractures, there is evidence that the prevalences of osteoporosis and fractures increase with age, that the short-term risk of fracture can be estimated by bone measurement tests and risk factor assessment, and that treatment may reduce fracture risk among women with low bone density DATA SYNTHESIS: Although many studies have been published about osteoporosis in postmenopausal women, there have been no trials of screening and, therefore, no direct evidence that screening improves outcomes. Instruments developed to assess clinical risk factors for low bone density or fractures generally have moderate-to-high sensitivity and low specificity, many have not been validated, and none have been widely tested in a practice setting. Among different bone density tests measured at various sites, bone density measured at the femoral neck by dual-energy x-ray absorptiometry is the best predictor of hip fracture and is comparable to forearm measurements for predicting fractures at other sites. Women with low bone density have a 40% to 50% reduction in fracture risk when treated with raloxifene (vertebral fractures) or bisphosphonates (both vertebral and nonvertebral fractures). Trials of estrogen are inconclusive because of methodologic limitations. CONTEXT: The incidence of osteoporotic fractures increases with age and is associated with a significant health burden. OBJECTIVE: To examine evidence on the benefits and harms of screening asymptomatic postmenopausal women for osteoporosis. DATA SOURCES: MEDLINE (1966 to May 2001), HealthSTAR (1975 to May 2001), and Cochrane databases, reference lists of systematic reviews, and experts. STUDY SELECTION: We included English-language abstracts with original data about postmenopausal women and osteoporosis that addressed the effectiveness of risk factor assessment, bone measurement tests, or treatment. Two reviewers read each abstract to determine its eligibility. DATA EXTRACTION: We extracted selected information about the patient population, interventions, clinical endpoints, and study design, and applied a set of criteria to evaluate study quality. |
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| Item Description: | Title from HTML header |
| Physical Description: | 1 PDF file |