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Association between screening for osteoporosis and the incidence of hip fracture.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Association between screening for osteoporosis and the incidence of hip fracture. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Kern, LM, Powe, NR, Levine, MA, Fitzpatrick, AL, Harris, TB, Robbins, J, Fried, LP |
| Journal | Ann Intern Med |
| Volume | 142 |
| Issue | 3 |
| Pagination | 173-81 |
| Date Published | 2005 Feb 01 |
| ISSN | 1539-3704 |
| Keywords | Absorptiometry, Photon, Aged, Aged, 80 and over, Cohort Studies, Female, Hip Fractures, Humans, Incidence, Male, Mass Screening, Osteoporosis, Risk Factors, Sensitivity and Specificity |
| Abstract | <p><b>BACKGROUND: </b>Because direct evidence for the effectiveness of screening is lacking, guidelines disagree on whether people should be screened for osteoporosis.</p><p><b>OBJECTIVE: </b>To determine whether population-based screening for osteoporosis in older adults is associated with fewer incident hip fractures than usual medical care.</p><p><b>DESIGN: </b>Nonconcurrent cohort study.</p><p><b>SETTING: </b>Population-based cohort enrolled in the Cardiovascular Health Study (CHS) from 4 states (California, Pennsylvania, Maryland, and North Carolina).</p><p><b>PATIENTS: </b>3107 adults 65 years of age and older who attended their CHS study visits in 1994-1995.</p><p><b>MEASUREMENTS: </b>31 participant characteristics (including demographic characteristics, medical histories, medications, and physical examination findings) and incident hip fractures over 6 years of follow-up.</p><p><b>INTERVENTION: </b>Bone density scans (dual-energy x-ray absorptiometry [DEXA] at the hip) for participants in California and Pennsylvania (n = 1422) and usual care for participants in Maryland and North Carolina (n = 1685).</p><p><b>RESULTS: </b>The incidence of hip fractures per 1000 person-years was 4.8 in the screened group and 8.2 in the usual care group. Screening was associated with a statistically significant lower hazard of hip fracture than usual care after adjustment for sex and propensity to be screened (Cox proportional hazard ratio, 0.64 [95% CI, 0.41 to 0.99]).</p><p><b>LIMITATIONS: </b>The mechanism of the association was unclear. A small unmeasured confounder that decreased the hazard of hip fracture could diminish or erase the observed association.</p><p><b>CONCLUSIONS: </b>Use of hip DEXA scans to screen for osteoporosis in older adults was associated with 36% fewer incident hip fractures over 6 years compared with usual medical care. Further research is needed to explore the mechanism of this association.</p> |
| DOI | 10.7326/0003-4819-142-3-200502010-00007 |
| Alternate Journal | Ann Intern Med |
| PubMed ID | 15684205 |
| Grant List | 1-Y02-HC-40205 / HC / NHLBI NIH HHS / United States K24DK02643 / DK / NIDDK NIH HHS / United States N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States Y02-AG-4-0251 / AG / NIA NIH HHS / United States |