Absolute fracture risk reporting in clinical practice: a physician-centered survey.
Non-expert clinical practitioners who had received bone density reports based on 10-year absolute fracture risk were surveyed to determine their response to this new system. Absolute fracture risk reporting was well received and was strongly preferred to traditional T-score-based reporting. Non-specialist physicians were particularly supportive of risk-based bone mineral density (BMD) reporting.


BACKGROUND
Absolute risk estimation is preferable to risk categorization based upon BMD alone. The objective of this study was to specifically assess the response of non-expert clinical practitioners to this approach.


METHODS
In January 2006, the Province of Manitoba, Canada, started reporting 10-year osteoporotic fracture risks for patients aged 50 years and older based on the hip T-score, gender, age, and multiple clinical risk factors. In May 2006 and October 2006, a brief anonymous survey was sent to all physicians who had requested a BMD test during 2005 and 206 responses were received.


RESULTS
When asked whether the report contained the information needed to manage patients, the mean score for the absolute fracture risk report was higher than for the T-score-based report (p<0.0001). When asked whether the report was easy to understand, the mean score for the absolute fracture risk report was again higher than for the T-score-based report (p<0.0001). Non-specialists gave a higher ranking than specialists to the absolute fracture risk information (p<0.05).


CONCLUSIONS
Absolute fracture risk reporting is well-received by physicians and is strongly preferred to traditional T-score-based reporting. Non-specialist physicians are particularly supportive of risk-based BMD reporting.
Leslie
W D
WD
Department of Medicine, University of Manitoba, 409 Tache Avenue, Winnipeg R2H 2A6 Manitoba, Canada. bleslie@sbgh.mb.ca
D015502:Absorptiometry, Photon; D015519:Bone Density / Q000502:physiology; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000191:economics / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008350:Manitoba; D010024:Osteoporosis / Q000191:economics / Q000503:physiopathology* / Q000532:radiotherapy; D010820:Physicians / Q000706:statistics & numerical data; D011364:Professional Practice; D018570:Risk Assessment / Q000191:economics / Q000592:standards*; D013038:Specialization / Q000706:statistics & numerical data