Assessment of physician responses to abnormal results of bone densitometry studies.
OBJECTIVE
To assess how physicians who have ordered bone densitometry studies respond to abnormal results.


METHODS
We conducted a retrospective review of cases from physicians affiliated with a community teaching hospital. The study sample consisted of 142 female patients with abnormal bone mineral density (BMD) who had been referred by 50 physicians (internists or gynecologists). A questionnaire was completed for each patient, providing data about further investigations, treatment interventions, and frequency of referral to a specialist in bone diseases.


RESULTS
Of the patients diagnosed with osteoporosis on the basis of BMD studies, 20.4% had no further investigations, and 27.8% underwent only mammography. Of all the patients with osteoporosis, 10.6% received no therapy (calcium and vitamin D excluded). The majority of all patients (71.8%) received a combination of calcium and vitamin D. The most common treatment modality was hormone replacement therapy. The second most common treatment strategy was bisphosphonates. The percentage of all referrals to specialists in metabolic bone diseases was low--11.3% in the patients of internists and 14.5% in the patients of gynecologists.


CONCLUSIONS
In this study, the information provided by bone densitometry did not affect management in a substantial percentage of patients. A considerable percentage of patients underwent no further investigations to rule out secondary causes of osteoporosis.
Economides
P A
PA
Department of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts 02162, USA.
Kaklamani
V G
VG
Karavas
I
I
Papaioannou
G I
GI
Supran
S
S
Mirel
R D
RD
D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002136:Calcium, Dietary / Q000627:therapeutic use; D003720:Densitometry; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging* / Q000628:therapy*; D010820:Physicians; D011859:Radiography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000627:therapeutic use
D002136:Calcium, Dietary; D004164:Diphosphonates; D014807:Vitamin D