Bone densitometry worldwide: a global survey by the ISCD and IOF

Abstract

Purpose: whilst the use of dual-energy x-ray absorptiometry (DXA) has been widely adopted worldwide for the assessment of bone mineral density, the quality of DXA facilities is unknown. To address this, a global survey of Fracture Liaison Services (FLS) was conducted by the International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) to assess the quality of their DXA facilities.
Methods: a questionnaire for the accessibility and quality of DXA services was co-created by representatives of the ISCD and the IOF and made available to institutions who participated in the Capture the Fracture Best Practice Framework. From a list of 331 contacted invitees, 124 FLS centres responded; analyses were based on 121 centres with suitable data.
Results: over 70% of institutions reported that, for over 90% of the time, DXA access met service needs and the scanning/reporting quality was perceived as excellent. However, 25% of DXA facilities reported not being accredited by a professional/governmental organisation and adherence to some basic DXA quality assurance and reporting procedures was confirmed by <50% of services. Importantly, in excess of 50% of institutions stated that they desired ongoing education in osteoporosis and DXA for operators and interpreters.
Conclusion: there is significant variability in the access to and quality of DXA services for established FLS worldwide. Despite two decades of training initiatives in osteoporosis densitometry, many centres are falling short of the standards of the IOF-ISCD Osteoporosis Essentials criteria.

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Identifiers

ORCID for Michael Clynes: orcid.org/0000-0001-7597-7658

ORCID for Elaine Dennison: orcid.org/0000-0002-3048-4961

ORCID for Nicholas Harvey: orcid.org/0000-0002-8194-2512

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

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