title: [Assessment of a set of FRAX(®)-based criteria for the indication of bone densitometry in Spanish postmenopausal women].
abstract: OBJECTIVE
  To assess the effect of the application in routine clinical practice of a proposal of thresholds for the indication of bone densitometry in Spanish postmenopausal women.
  
  
  METHODS
  We determined the risk of major fracture (RMF) by FRAX(®) of the patients referred to a bone densitometry unit from Primary Care who were untreated. We calculated how many scans would have been avoided if they had been performed only to women ≥ 65 years with a RMF < 10% or women<65 years with a RMF ≥ 3.6%.
  
  
  RESULTS
  We included 643 women with a mean age of 61 (9) years. Twenty-three percent had a normal bone mineral density, 56% had osteopenia, and 21% osteoporosis. The RMF was 5.9 (5.5)%. Eighty of 217 (37%) bone scans in women ≥ 65 years and 273 of 426 (64%) in women<65 years would have been avoided. As a whole, 55% of the scans would have been avoided. The sensitivity of the threshold of 3.6% of RMF for the diagnosis of osteoporosis was 51%, specificity 68%, positive predictive value 20%, and negative predictive value 20%.
  
  
  CONCLUSIONS
  The application of the proposed thresholds for the indication of bone densitometry in Spanish postmenopausal women, based on age and risk of fracture calculated by FRAX(®) would result in a significant decrease of the activity of the bone densitometry unit.
authors.affiliation: Servicio de Reumatología, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. carmen.gomez@bellvitgehospital.cat
authors.forename: Carmen
authors.initials: C
authors.lastname: Gómez-Vaquero
authors.forename: Daniel
authors.initials: D
authors.lastname: Roig-Vilaseca
authors.forename: María
authors.initials: M
authors.lastname: Bianchi
authors.forename: Pilar
authors.initials: P
authors.lastname: Santo
authors.forename: Javier
authors.initials: J
authors.lastname: Narváez
authors.forename: Joan M
authors.initials: JM
authors.lastname: Nolla
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000368:Aged; D000465:Algorithms; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures