The Resource Screening for osteoporosis : systematic review to update the 2002 U.S. preventive services task force recommendation, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; Oregon Evidence-based Practice Center, Oregon Health & Science University ; investigators, Heidi D. Nelson ... [et al.], (electronic resource)

Screening for osteoporosis : systematic review to update the 2002 U.S. preventive services task force recommendation, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; Oregon Evidence-based Practice Center, Oregon Health & Science University ; investigators, Heidi D. Nelson ... [et al.], (electronic resource)

Label
Screening for osteoporosis : systematic review to update the 2002 U.S. preventive services task force recommendation
Title
Screening for osteoporosis
Title remainder
systematic review to update the 2002 U.S. preventive services task force recommendation
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; Oregon Evidence-based Practice Center, Oregon Health & Science University ; investigators, Heidi D. Nelson ... [et al.]
Contributor
Subject
Language
  • eng
  • eng
Summary
BACKGROUND: Osteoporosis and related fractures are common in older individuals and lead to premature mortality, loss of function and independence, reduced quality of life, and high costs. Despite its importance, osteoporosis is under detected in the United States. This review updates evidence since the 2002 U.S. Preventive Services Task Force recommendation on osteoporosis screening. PURPOSE: To determine the effectiveness and harms of osteoporosis screening in reducing fractures for men and postmenopausal women without known previous fractures; the performance of risk-assessment instruments and bone measurement tests in identifying persons with osteoporosis; optimal screening intervals; and efficacy and harms of medications to reduce primary fractures. DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the 4th Quarter of 2009), MEDLINE (January 2001 to December 2009), reference lists, and Web of Science searches. STUDY SELECTION: Randomized, controlled trials of screening or medications with fracture outcomes published in English; performance studies of validated risk-assessment instruments; and systematic reviews and population-based studies of bone measurement tests or medication harms. DATA EXTRACTION: Data on patient populations, study design, analysis, follow-up, and results were abstracted; study quality was rated by using criteria developed by the USPSTF. DATA SYNTHESIS: Risk-assessment instruments are modest predictors of low bone density (area under the curve, 0.13 to 0.87; 14 instruments) and fractures (area under the curve, 0.48 to 0.89; 11 instruments); simple and complex instruments perform similarly. Dual-energy x-ray absorptiometry predicts fractures similarly for men and women; calcaneal quantitative ultrasonography also predicts fractures, but correlation with dual-energy x-ray absorptiometry is low. Repeating a bone density measurement up to 8 years after an initial measurement does not significantly improve predictive performance for fracture outcomes. For postmenopausal women, bisphosphonates, parathyroid hormone, raloxifene, and estrogen reduce primary vertebral fractures; bisphosphonates reduce primary nonvertebral fractures in sensitivity analysis. Medications are effective for bone density T-scores of 2.5 or less for women without previous known fractures. Primary prevention trials are lacking for men. Bisphosphonates are not consistently associated with serious adverse events; raloxifene and estrogen increase thromboembolic events; estrogen increases stroke; and estrogen with progestin increases coronary heart disease and breast cancer. LIMITATIONS: Trials of screening with fracture outcomes, screening intervals, and medications to reduce primary fractures, particularly enrolling men, are lacking. CONCLUSIONS: Although methods to identify risk for osteoporotic fractures are available and mediations to reduce fractures are effective, no trials directly evaluate screening effectiveness, harms, and intervals
Member of
Cataloging source
DNLM
Funding information
This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) Oregon Health & Science University, Mail Code BICC, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098. www.ohsu.edu/epc under contract to the Agency for Healthcare Research and Quality (AHRQ), 540 Gaither Road, Rockville, MD 20850. www.ahrq.gov Rockville, MD (Contract No. 290-2007-10057-I-EPC3, Task Order Number 3).
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WE 250
http://library.link/vocab/relatedWorkOrContributorName
  • Nelson, Heidi D
  • United States
  • Oregon Health & Science University
Series statement
  • Evidence syntheses
  • AHRQ publication
Series volume
  • no. 77
  • no. 10-05145-EF-1
http://library.link/vocab/subjectName
  • Osteoporosis
  • Osteoporotic Fractures
  • Risk Assessment
  • Preventive Health Services
  • Randomized Controlled Trials as Topic
  • United States
Label
Screening for osteoporosis : systematic review to update the 2002 U.S. preventive services task force recommendation, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; Oregon Evidence-based Practice Center, Oregon Health & Science University ; investigators, Heidi D. Nelson ... [et al.], (electronic resource)
Instantiates
Publication
Note
  • Title from PDF t.p
  • "July 2010."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Form of item
online
Specific material designation
remote
System control number
  • 1553824
  • (DNLM)BKSHLF:NBK45201
System details
Mode of access: Internet
Label
Screening for osteoporosis : systematic review to update the 2002 U.S. preventive services task force recommendation, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; Oregon Evidence-based Practice Center, Oregon Health & Science University ; investigators, Heidi D. Nelson ... [et al.], (electronic resource)
Publication
Note
  • Title from PDF t.p
  • "July 2010."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Form of item
online
Specific material designation
remote
System control number
  • 1553824
  • (DNLM)BKSHLF:NBK45201
System details
Mode of access: Internet

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