BMJ 1995;311:1301 (11 November)

Letters

Different guidelines will yield different estimates of prevalence

EDITOR,--J E Compston and colleagues suggest that in clinical practice patients should be selected for bone densitometry on the basis of clinical or historical risk factors.1 Having recently assessed the guidelines on the detection of osteoporosis that operated during the first year of operation of the bone densitometry service in the Wirral, we would point out that care is needed in selecting criteria for bone densitometry as different criteria lead to different rates of detection of disease.

We have the only densitometer in Wirral, which has a catchment population of 365000. Our guidelines stated that the following categories of patients would be eligible for scanning: women who had taken hormone replacement therapy for 18 months, to determine whether the treatment should be continued; women who were unable to take hormone replacement therapy; women who had sustained a trivial fracture (including vertebral fractures); women taking corticosteroids; and private referrals.

Altogether 435 . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Bone densitometry in clinical practice
J E Compston, C Cooper, and J A Kanis
BMJ 1995 310: 1507-1510. [Abstract] [Full Text]

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