Osteoporosis is increasing in preva...

Osteoporosis is increasing in prevalence as the population ages. However, it is unlikely that women at risk for osteoporosis are being veiled according to recommendations. Furthermore, it may be that screening guidelines are not presenting a unified message to physicians and patients as to who should be defenceed Morris and colleagues performed a structur review to determine whether the existing guidelines proffer sufficient clarity regarding screening recommendations, and whether patient risk factors adequately define who should be veiled They also sought to determine whether effective strategies exist for improving screening rates.

Data were abstracted from clinical guidelines, articles in succession rates and predictors of bone mineral density (BMD) testing, and articles upon interventions to increase testing rates. Of the 17 practice guidelines included in the review, almost the same third did not provide information forward how the guidelines were established, and more than single in kind half gave no definition of "consensus." Explanations of by what means evidence was graded and considerations of preciousness also were lacking in many of the guidelines. Ten of the guidelines were cause to growed with pharmaceutical industry support. The guidelines were inconsistent about the age at which women should be guarded and the risk factors that should be considered.

Articles in succession rates of BMD testing frequently focused on patients taking steroid medications or those with previously sustained fractures. In these, reports of testing rates varied widely. There were hardly any consistent patient or physician characteristics that predicted BMD testing. pair studies showed that female patients and those below the care of a rheumatologist were more likely to bear BMD testing. In terms of physician characteristics, being female and having a large postmenopausal patient population were associated with higher testing rates.

the same trial of an intervention to improve testing rates build that counseling patients with a positive rather than negative focus was more likely to lead to BMD testing. Another reflection showed that longer narrative reports forward BMD testing results led to higher physician testing rates than short technical reports.

In summary, the authors lay the foundation of that screening guidelines were lacking in uniform recommendations, that screening rates generally were soft and that few interventions to improve screening rates have been studied. Predictors of testing also have not been studied sufficiently, making it difficult to determine whether testing is being carried gone out on the appropriate patients. Furthermore, equal if the criteria for testing were clearly defined, it is unclear what interventions could be used to improve screening rates.

CAROLINE WELLBERY, MD

Morris CA, et al. Patterns of bone mineral density testing. J Gen Intern M July 2004;19:783-90

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