Screening for osteoporosis: an update for the U.S. Preventive Services Task Force.

Annals of Internal Medicine
Heidi D NelsonRoger Chou

Abstract

This review updates evidence since the 2002 U.S. Preventive Services Task Force recommendation on osteoporosis screening. To determine the effectiveness and harms of osteoporosis screening in reducing fractures for men and postmenopausal women without known previous fractures; the performance of risk-assessment instruments and bone measurement tests in identifying persons with osteoporosis; optimal screening intervals; and the efficacy and harms of medications to reduce primary fractures. Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2009), MEDLINE (January 2001 to December 2009), reference lists, and Web of Science. Randomized, controlled trials of screening or medications with fracture outcomes published in English; performance studies of validated risk-assessment instruments; and systematic reviews and population-based studies of bone measurement tests or medication harms. Data on patient populations, study design, analysis, follow-up, and results were abstracted, and study quality was rated by using established criteria. Risk-assessment instruments are modest predictors of low bone density (area under the curve, 0.13 to 0.87; 14 instruments) and fra...Continue Reading

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