HealthDay News — Combined assessment of bone strength and bone mineral density is a cost-effective strategy for osteoporosis screening in postmenopausal women, according to a study published in Radiology.

Christoph A. Agten, MD, from the NYU Langone Medical Center in New York City, and colleagues created a model to investigate whether assessment of bone strength with quantitative computed tomography (CT) in combination with dual-energy x-ray absorptiometry (DXA) is cost-effective as a screening tool for osteoporosis in postmenopausal women (≥55 years).

The researchers found that the most cost-effective strategy was combined DXA and quantitative CT screening starting at age 55 with quantitative CT screening every 5 years (incremental cost-effectiveness ratio, $2000 per quality-adjusted life year). With this strategy, 12.8% of postmenopausal women sustained hip fractures in their remaining life versus 18.7% with no screening and 15.8% with DXA screening. 


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Vertebral fractures would happen in 7.5%, 11.1%, and 9%, respectively, while wrist fractures were predicted in 14%, 17.8%, and 16.4%, respectively. DXA and quantitative CT at age 55 years with quantitative CT screening every 5 years was the best strategy in more than 90% of the 1000 simulations.

“Combined assessment of bone strength and bone mineral density is a cost-effective strategy for osteoporosis screening in postmenopausal women and has the potential to prevent a substantial number of fragility fractures,” the authors write.

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Reference

Agten CA, Ramme AJ, Kang S, Honig S, Chang G. Cost-effectiveness of virtual bone strength testing in osteoporosis screening programs for postmenopausal women in the United States. Radiology. 2017;285(2):506-517.