دانلود رایگان مقاله دستگاه تشخیصی پوکی استخوان در جمعیت عمومی

ABSTRACT

Introduction: A diagnostic gap exists in the current dual photon X-ray absorptiometry (DXA) based diagnostic approach to osteoporosis. Other diagnostic devices have been developed, but no comprehensive review concerning the applicability of these diagnostic devices for population-based screening have been performed. Material and methods: A systematic review of Embase, Medline and the Cochrane Central Register for Controlled Trials was performed for population-based studies that focused on technical methods that could either indicate bone mineral density (BMD) by DXA, substitute for DXA in prediction of fracture risk, or that could have an incremental value in fracture prediction in addition to DXA. Quality of included studies was rated by QUADAS 2. Results: Many other technical devices have been tested in a population-based setting. Five studies aiming to indicate BMD and 17 studies aiming to predict fractures were found. Overall, the latter studies had higher methodological quality. The highest number of studies was found for quantitative ultrasound (QUS). The ability to indicate BMD or predict fractures was moderate to minor for all examined devices, using reported area under the curve (AUC) of Receiver Operating Characteristic curves values as standard. Conclusions: Of the methods assessed, only QUS appears capable of perhaps replacing DXA as standalone examination in the future whilst radiographic absorptiometry could provide important information in areas with scarcity of DXA. QUS may be of added value even after DXA has been performed. Evaluation of proposed cutoff-values from population-based studies in separate population-based cohorts is still lacking for most examination devices

Disclosures

MPH reports personal fees from Lilly (past, within 36 months) and personal fees from Sanofi (past, within 36 months), outside the submitted work, MPH is a full time employee of Boehringer-Ingelheim, outside the submitted work. KHR has no disclosures. HAP reports personal fees from Amgen, personal fees from MSD, grants and personal fees from Eli Lilly, personal fees from Shire, outside the submitted work; KB reports investigator fees paid to his department by Amgen (past, within 36 months), investigator fees paid to his department by Merck (past, within 36 months), investigator fees paid to his department by Novartis (past, within 36 month) and investigator fees paid to his department by NPS (past, within 36 months), outside the submitted work. BA reports research grants from Novartis (current), personal fees from Nycomed/Takeda (past, within 36 months), personal fees from Merck (past, within 36 months), personal fees from Amgen (past, within 36 months), grants from UCB (current), outside the submitted work.