Lack of conveniently available BMD testing has been proposed as a reason for the reported under-diagnosis of osteoporosis. With appropriate T-score cut-points, peripheral BMD devices could be used for screening prior to referral to DXA, increasing the proportion of eligible individuals receiving a more definitive BMD test. The goal of this study was to evaluate results from radiographic absorptiometry of the phalanges (RA) that would provide sensitivity and specificity appropriate for identifying patients that should receive a central DXA test. In this study, 943 patients (876 females (F), mean age=59.7±10.8; 67 males (M), mean age=63.3±12.0) referred for central DXA were also tested using RA (MetriScan®, Alara Inc., Fremont, CA). The RA results were examined as a diagnostic for osteoporosis (central DXA T-score ≤ -2.5, overall incidence in hip or spine = 12.5%) using receiver operating characteristic (ROC) analysis. For an RA T-score cut-point of -1.0, the following correlations were obtained: F (hip only): sensitivity = 94.1%, specificity = 60.6%, 55% of false positives (FP) were osteopenic according to DXA; F (lowest of hip and L2-L4 spine): sensitivity = 86.2%, specificity = 62.2%, 66% of FP were osteopenic; M and F (hip only): sensitivity = 91.1%, specificity = 57.9%, 61% of FP were osteopenic; M and F (lowest of hip and L2-L4 spine): sensitivity = 86.9%, specificity = 60.0%, 70% of FP were osteopenic. We conclude that RA, with an appropriately chosen T-score cut-point, could be effectively used to screen patients for further study with central DXA.
Disclosure Information:
Faculty Member's Name: Christopher R. Mitchell, Ph.D.
Other Financial or Material Support: Employee of Alara Incorporated
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