The researchers found that combining four clinical risk factors -- older age, history of fracture, a failed chair test or a recent fall, with a low heel ultrasound score was better at predicting the risk of a future fracture than ultrasound alone. A failed chair test meant that a woman couldn't rise from a chair three successive times without using the arms of the chair.
By using the two methods together -- what the researchers called the predictive rule -- they were able to better identify which women were at-risk for a fracture.
Of those women who had a fracture, 90 percent were identified as high risk using the predictive rule.
Chervenak said there are drawbacks to this method, however. She explained that there are two types of bone that need to be assessed: cortical, which is found in the hip, and trabecular, which is found in the spine. Ultrasound is good for assessing cortical bone, but will likely miss problems in trabecular bone.
Additionally, she said that there is no standardized ultrasound test yet, and different centers use different machines.
The bottom line, Chervenak said, is that she doesn't think bone density testing will change significantly any time soon. This is a "well-designed study, and they're trying to create an easy-to-use algorithm, but assessing risk is a skill, and each woman has to be assessed individually," she concluded.
To learn more about bone density testing, visit the National Osteoporosis Foundation.
SOURCES: Idris Guessous, M.D., senior research fellow, Lausanne Un
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