Clinical uses of densitometry are not yet proved

EDITOR,—J E Compston and colleagues review the indications for bone densitometry in clinical practice.1 They agree with the conclusions of the Effective Health Care bulletin that there is insufficient evidence to justify screening women at the menopause.2 Several of their other recommendations, however, do not seem to be supported by the evidence.

The authors propose that bone densitometry should be used, for example, for people with strong clinical risk factors. This is justified only if the information provided by the test can influence decision making in a way that improves the effectiveness or cost effectiveness of treatment.3 However, no evidence is cited to show that decision making is improved as …