Are Women Being Overtreated for Osteoporosis?
Younger women who aren’t at risk of bone fractures are being improperly diagnosed and treated for osteoporosis, according to a new research letter.
To be diagnosed with osteoporosis, patients have to undergo a dual-energy x-ray absorptiometry (DXA) screening. However, DXA screenings include T scores for anatomic sites that international guidelines advise against using when diagnosing osteoporosis.
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The screenings are most beneficial to women over 65 years old and women with a high-risk of bone fractures because they are at the highest risk of osteoporosis.
To understand how many patients are being misdiagnosed, researchers analyzed records from 6150 women aged 40 to 85 who received an initial DXA screening between 2006 and 2011 at the University of California Davis health system.
Researchers found that 66% of patients who were introduced to treatment after their initial screening didn’t have osteoporosis or were diagnosed against international guidelines. Also, 50% of those patients were younger than 65 and didn’t exhibit risk factors.
The researchers concluded that in order to avert overtreatment, T scores should only be reported only when sites are consistent with International Society for Clinical Densitometry guidelines to avoid making osteoporosis diagnoses based on nondiagnostic sites.
--Amanda Balbi
Reference:
Fenton JJ, Robbins JA, Amarnath ALD, and Franks P. Osteoporosis overtreatment in a regional health care system. JAMA Intern Med. Published online January 4, 2016. doi:10.1001/jamainternmed.2015.6020.