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DXA scores likely still necessary to accurately diagnose osteoporosis
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SEATTLE — Dual-energy X-ray absorptiometry scores are still a superior means compared with radiographic data alone in the diagnosis of osteoporosis, according to research presented at the American Society for Surgery of the Hand Annual Meeting.
“[Physicians] certainly do a better job of differentiating between normal and abnormal in a slight majority, but only with fair to moderate agreement between physicians and with a poor negative predictive value,” Andrew J. Miller, MD, said, here.
Miller and colleagues performed digital hand and wrist radiographs for 34 female patients older than 65 years who presented to a single hand clinic. Five fellowship-trained hand surgeons independently evaluated imaging data and classified patients at initial presentation and 4-week follow-up as either osteoporotic, osteopenic or of normal bone mineral density. Accuracy relative to patient’s dual-energy X-ray absorptiometry (DXA) scores were calculated and the accuracy of the surgeons’ assessments were determined at both time points.
The researchers found that for DXA scores, surgeon accuracy was observed in 169 of 340 (49%) evaluations of the imaging data. Overestimation of bone mineral density occurred in 51% of the assessments, while underestimation was seen for 49% of the assessments. Surgeon inaccuracy by one grade was noted in 83% of evaluations while two-grade inaccuracy occurred in 17%. – by Christian Ingram
Reference:
Miller AJ. Paper #40. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 10-12, 2015; Seattle.
Disclosure: Miller reports no relevant financial disclosures.