Validation of the Dutch guidelines for dual X-ray absorptiometry measurement

Br J Gen Pract. 2009 Apr;59(561):256-60. doi: 10.3399/bjgp09X420338.

Abstract

Background: In Europe, a case-finding strategy for osteoporosis is recommended above widespread population-based screening. However, no universally accepted policy currently exists. In 2005, the Dutch College of General Practitioners published guidelines for GPs to select patients for dual energy X-ray absorptiometry (DXA).

Aim: To evaluate the sensitivity, specificity, and predictive value of the Dutch guidelines to select participants with osteoporosis for DXA.

Design of study: Cross-sectional.

Setting: A total of 345 females aged over 50 years (mean age = 62 years, standard deviation [SD] = 8.3) and 99 males over 65 years of age (mean age = 72 years, SD = 5.2) of a Dutch general practice.

Method: Calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Dutch case-finding instrument for selecting patients with osteoporosis for DXA measurement.

Results: Sensitivity was 19.5%, specificity 85.6%, PPV 18.6%, and NPV 86.6%.

Conclusion: The Dutch guidelines are unreliable in detecting people at risk for osteoporosis.

Publication types

  • Evaluation Study
  • Validation Study

MeSH terms

  • Absorptiometry, Photon*
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Osteoporosis / diagnostic imaging*
  • Osteoporosis / prevention & control
  • Practice Guidelines as Topic / standards*
  • Predictive Value of Tests
  • Risk Factors
  • Sensitivity and Specificity