DXA quality matters.

The proliferation of devices to measure bone mineral density (BMD), with large numbers of technologists operating these instruments and numerous physicians interpreting/reporting the results, raises concern regarding the quality of the studies. High quality BMD measurement and reporting is essential, since referring healthcare providers rely on these reports to make patient care decisions that include additional medical evaluation (laboratory or imaging tests), drug therapy (starting, stopping, or changing), and possibly referral to an osteoporosis specialist. Incorrect BMD acquisition or reporting may generate unnecessary medical expenses and result in therapeutic decisions that could be harmful to patients. Contrary to the common misperception that BMD measurement and interpretation is a simple procedure requiring no special expertise, densitometer maintenance/operation, data acquisition, and interpretation/reporting of the results are skills that must be acquired and maintained. We recommend that technologists and clinicians involved with performing or interpreting BMD tests be educated and trained in bone densitometry and that they update their skills regularly. We also suggest that they provide demonstration of proficiency in bone densitometry in order to assure patients, referring healthcare providers, and payers of medical services that these skills have been acquired and maintained.