What should DXA reports contain? Preferences of ordering health care providers

It has previously been reported that clinicians prefer detailed dual-energy X-ray absorptiometry (DXA) reports. However, there are limited recent data to support this contention. Given the emphasis on bone mass measurement and osteoporosis treatment that occurred over the past decade, we hypothesized that clinicians would no longer desire detailed DXA reports. As such, we surveyed 234 university health care providers who had ordered one or more DXA scans from October 2005 through February 2006. All providers were requested to complete an anonymous survey expressing their preferences regarding potential elements of a central DXA report using a 1-5 scale. Of the 234 surveys sent, 116 (50%) were returned. Over 90% felt that DXA reports should include a statement regarding the study's technical quality and limitations, the T-score and definition of significant change. Similarly, over 80% felt that a statement about fracture risk and the BMD least significant change to be essential or helpful. Although a majority of clinicians requested recommendations for non-BMD testing, pharmacologic/nonpharmacologic interventions and specific recommendations for evaluation of secondary osteoporosis, a substantial minority (approximately 20%) found such recommendations either not required or definitely unnecessary. That this survey was conducted among university clinicians is a limitation, which may impact generalizability. In conclusion, clinicians responding to this survey continue to prefer detailed DXA reports with over 60% desiring inclusion of all the components recommended for DXA reports by the International Society for Clinical Densitometry. Despite the finding that a majority of providers continue to request such "consultative" reports, DXA interpreters should be cautioned that this approach requires fairly extensive and accurate clinical information and that not all clinicians desire recommendations for additional evaluation and treatment.