The importance of spectrum bias on bone density monitoring in clinical practice

Bone
William D Leslie, Manitoba Bone Density Program

Abstract

Spectrum bias can occur if a diagnostic test is applied to a patient population of different disease severity than was used in the original test validation. Despite recommendations that bone mineral density (BMD) precision and follow-up assessment be based upon absolute measurements (in g/cm(2)), the use of relative change (in percent) is still frequently encountered. The current study was undertaken to compare absolute and relative precision and change in bone mineral density (BMD) categorization for lower and higher BMD ranges. Patients with baseline and follow-up BMD measurements (1,317 spine pairs and 1,259 hip scan pairs) were identified in the population-based Manitoba Bone Density Program database (1994-2002). Relative (percent) and absolute (g/cm(2)) least significant change (LSC) limits were from a convenience sample from the same population (198 spine scan pairs and 193 hip scan pairs). The main outcome measure was the fraction with BMD change exceeding LSC limits. BMD range strongly affected change category using a pooled relative LSC (lower 33.5% versus higher 20.0%, P < 0.0001) but a range-concordant LSC eliminated this difference (lower 28.3% versus higher 27.1%, P > 0.2). Categorization according to absolute LSC ...Continue Reading

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Citations

Aug 11, 2006·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Manitoba Bone Density Program
Apr 23, 2008·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·M SadatsafaviW D Leslie
Jul 18, 2008·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·S MorinW D Leslie
Feb 25, 2009·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Manitoba Bone Density Program
May 12, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieM S Yogendran
Aug 12, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·R RajamanoharaG M Blake
Oct 23, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Canadian Multicentre Osteoporosis Study Research Group
Dec 17, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieJ A Kanis
Mar 3, 2011·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Manitoba Bone Density Program
May 13, 2011·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·J M PritchardW D Leslie
Oct 20, 2011·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Manitoba Bone Density Program
Jun 28, 2012·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieUNKNOWN Manitoba Bone Density Program
Oct 12, 2012·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·M A KriegUNKNOWN Manitoba Bone Density Program
Sep 15, 2010·Breast Cancer Research and Treatment·Debjani GrenierWilliam D Leslie
Feb 8, 2014·Transplantation·Kyla L NaylorAmit X Garg
Aug 6, 2014·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieS R Majumdar
Oct 21, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·W D LeslieJ A Kanis
Oct 30, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Laura E TargownikWilliam D Leslie
Aug 20, 2011·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·Donald R Duerksen, William D Leslie
Jul 5, 2011·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·William D LeslieUNKNOWN Manitoba Bone Density Program
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May 4, 2010·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·William D LeslieUNKNOWN Manitoba Bone Density Program
Nov 26, 2009·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·Jeffrey FrimethDave Webster
Sep 25, 2007·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·William D LeslieLiqun Wang
Oct 17, 2007·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·William D Leslie
Nov 5, 2011·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Lora M GiangregorioJohn A Kanis
Sep 15, 2010·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·William D LeslieUNKNOWN Manitoba Bone Density Program
Dec 15, 2012·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Laura E TargownikWilliam D Leslie
May 26, 2010·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·William D LeslieUNKNOWN Manitoba Bone Density Program
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