UNLABELLED: We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. INTRODUCTION: Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. METHODS: We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. RESULTS: Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. CONCLUSIONS: For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.
UNLABELLED: We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. INTRODUCTION: Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. METHODS: We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. RESULTS: Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. CONCLUSIONS: For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.
Authors: S R Cummings; D M Black; M C Nevitt; W S Browner; J A Cauley; H K Genant; S R Mascioli; J C Scott; D G Seeley; P Steiger Journal: JAMA Date: 1990-02-02 Impact factor: 56.272
Authors: Helena Johansson; Anders Oden; Olof Johnell; Bengt Jonsson; Chris de Laet; Alan Oglesby; Eugene V McCloskey; Karthik Kayan; Tarja Jalava; John A Kanis Journal: J Bone Miner Res Date: 2004-06 Impact factor: 6.741
Authors: Suzanne M Cadarette; Warren J McIsaac; Gillian A Hawker; Liisa Jaakkimainen; Alison Culbert; Gihane Zarifa; Ebele Ola; Susan B Jaglal Journal: Osteoporos Int Date: 2004-01-17 Impact factor: 4.507
Authors: J A Kanis; O Johnell; C De Laet; H Johansson; A Oden; P Delmas; J Eisman; S Fujiwara; P Garnero; H Kroger; E V McCloskey; D Mellstrom; L J Melton; H Pols; J Reeve; A Silman; A Tenenhouse Journal: Bone Date: 2004-08 Impact factor: 4.398
Authors: S R Cummings; D M Black; D E Thompson; W B Applegate; E Barrett-Connor; T A Musliner; L Palermo; R Prineas; S M Rubin; J C Scott; T Vogt; R Wallace; A J Yates; A Z LaCroix Journal: JAMA Date: 1998 Dec 23-30 Impact factor: 56.272
Authors: Marjolein van der Klift; Chris E D H de Laet; Eugene V McCloskey; Olof Johnell; John A Kanis; Albert Hofman; Huibert A P Pols Journal: J Bone Miner Res Date: 2004-02-23 Impact factor: 6.741
Authors: Peggy M Cawthon; Li-Yung Lui; Charles E McCulloch; Jane A Cauley; Misti L Paudel; Brent Taylor; John T Schousboe; Kristine E Ensrud Journal: J Gerontol A Biol Sci Med Sci Date: 2016-07-08 Impact factor: 6.053
Authors: Susan J Diem; Katherine W Peters; Margaret L Gourlay; John T Schousboe; Brent C Taylor; Eric S Orwoll; Jane A Cauley; Lisa Langsetmo; Carolyn J Crandall; Kristine E Ensrud Journal: J Gen Intern Med Date: 2017-08-16 Impact factor: 5.128
Authors: Jane A Cauley; Li-Yung Lui; Misti L Paudel; Brent C Taylor; Peggy M Cawthon; Teresa A Hillier; John T Schousboe; Charles E McCulloch; Kristine E Ensrud Journal: Bone Date: 2016-04-27 Impact factor: 4.398