Structured Abstract

Contents

• 1. Introduction
  • Purpose of Review and Prior USPSTF Recommendation
  • Condition Definition
  • Prevalence and Burden of Disease
  • Risk Factors
  • Rationale for Screening/Screening Strategies
  • Interventions/Treatment
  • Current Clinical Practice
  • Recommendations of Other Groups
• 2. Methods
  • Key Questions and Analytic Framework
  • Search Strategies
  • Study Selection
  • Data Abstraction and Quality Rating
  • Data Synthesis and Analysis
  • Sensitivity Analysis
  • Outcomes Table and Screening Strategies
  • Review of Draft
• 3. Results
  • Key Questions 1 and 4 Does screening for osteoporosis and low bone density reduce osteoporosis-related fractures and/or fracture-related morbidity and mortality in postmenopausal women and men age >50 years? What are the harms associated with osteoporosis screening?
  • Key Question 2 What valid and reliable risk-assessment instruments stratify women and men into risk categories for osteoporosis or fractures?
  • Key Question 3a How well does DXA predict fractures in men?
  • Key Question 3b How well do peripheral bone measurement tests predict fractures?
  • Key Question 3c What is the evidence to determine screening intervals for osteoporosis and low bone density?
  • Key Question 5 Do medications for osteoporosis and low bone density reduce osteoporosis-related fracture rates and/or fracture-related morbidity and mortality in the target populations?
  • Key Question 6 What are the harms associated with medications for osteoporosis and low bone density?
• 4. Discussion
  • Summary of Review Findings
  • Limitations
  • Future Research
  • Conclusions
• References
• Appendices
  • Appendix A Abbreviations
  • Appendix B Detailed Methods
  • Appendix C Appendix Figures
  • Appendix D Appendix Tables

The authors acknowledge the contributions of Rochelle Fu, PhD, for conducting statistical sensitivity analyses, and Andrew Hamilton, MLS, MS, for creating literature searches. Kenneth Lin, MD, served as the AHRQ Project Officer and Rosanne Leipzig, MD, PhD, Diana Petitti, MD, MPH, and George Sawaya, MD, were the U.S. Preventive Services Task Force leads for this project.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC)¹ under contract to the Agency for Healthcare Research and Quality (AHRQ),² Rockville, MD (Contract No. 290-2007-10057-I-EPC3, Task Order Number 3).

Suggested citation:

Nelson HD, Haney EM, Chou R, Dana T, Fu R, Bougatsos C. Screening for Osteoporosis: Systematic Review to Update the 2002 U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No. 77. AHRQ Publication No. 10-05145-EF-1. Rockville, Maryland: Agency for Healthcare Research and Quality, July 2010.

The investigators involved have declared no conflicts of interest with objectively conducting this research. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

1

Oregon Health & Science University, Mail Code BICC, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098. www​.ohsu.edu/epc

2

540 Gaither Road, Rockville, MD 20850. www​.ahrq.gov