Bone densitometry in clinical practice

BMJ 1995;311:686-687 (9 September)

Letters

Bone densitometry in clinical practice

Clinical uses of densitometry are not yet proved

EDITOR,--J E Compston and colleagues review the indicationsfor bone densitometry in clinical practice.¹ They agree withthe conclusions of the Effective Health Care bulletin that thereis insufficient evidence to justify screening women at the menopause.²Several of their other recommendations, however, do not seemto be supported by the evidence.

The authors propose that bone densitometry should be used, forexample, for people with strong clinical risk factors. Thisis justified only if the information provided by the test caninfluence decision making in a way that improves the effectivenessor cost effectiveness of treatment.³ However, no evidence iscited to show that decision making is improved as a result ofbone densitometry in people at increased risk of fracture dueto accelerated bone loss. Since the presence of multiple riskfactors is more important than the result of bone . . . [Full text of this article]