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Bone densitometry worldwide: a global survey by the ISCD and IOF
M A Clynes1, L D Westbury1, E M Dennison1,2
1MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Summary
Global fracture liaison services report good access to dual-energy X-ray absorptiometry (DXA) but variable quality. Many centers need more education on DXA procedures and quality assurance for bone density assessment.
Area of Science:
- Osteoporosis research
- Bone health diagnostics
- Healthcare quality assessment
Background:
- Dual-energy X-ray absorptiometry (DXA) is widely used for bone mineral density assessment.
- The quality of global DXA facilities remains largely unknown.
- A survey of fracture liaison services (FLS) was conducted to evaluate DXA facility quality.
Purpose of the Study:
- To assess the accessibility and quality of DXA services worldwide.
- To identify gaps in DXA quality assurance and reporting procedures.
- To understand educational needs for DXA operators and interpreters.
Main Methods:
- A global survey of FLS was conducted using a co-created questionnaire by the ISCD and IOF.
- Data were collected from 121 FLS centers participating in the Capture the Fracture Best Practice Framework.
- The survey focused on DXA accessibility, scanning/reporting quality, accreditation, and educational requirements.
Main Results:
- Over 70% of FLS reported adequate DXA access.
- Less than 50% of services adhered to basic DXA quality assurance and reporting standards.
- Over 50% of institutions expressed a need for ongoing education in DXA and osteoporosis management.
Conclusions:
- Significant variability exists in DXA service access and quality among FLS globally.
- Many centers do not meet established IOF-ISCD Osteoporosis Essentials criteria.
- There is a clear need for improved DXA quality control and operator/interpreter education worldwide.
