Less than half of DXA facilities surveyed adhere to quality assurance procedures

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Less than half of DXA facilities surveyed adhere to quality assurance procedures

by John R. Fischer, Senior Reporter | May 21, 2020
Women's Health X-Ray
Less than 50% of DXA facilities adhere to quality assurance and reporting procedures when assessing bone density on X-ray scans.
A new report indicates one quarter of facilities offering dual-energy X-ray absorptiometry (DXA) lack accreditation from professional or government organizations, while less than 50% adhere to basic quality assurance and reporting procedures.

That’s what the Medical Research Council Lifecourse Epidemiology Union (MRC LEU, University of Southampton) found after surveying 121 fracture liaison services, which are organizations that identify and treat patients at risk of secondary fractures. Working with the International Osteoporosis Foundation (IOF) and the International Society for Clinical Densitometry (ISCD), the MRC LEU, University of Southampton assessed the quality of each service's bone scanning facilities.

"Although DXA service access meets needs, many centers are falling short of quality standards,” professor Christopher Shuhart, co-author and immediate past president of ISCD, said in a statement. “The findings emphasize the need for educational initiatives targeting DXA measurement technology and reporting, such as adoption of the joint IOF-ISCD Osteoporosis Essentials course."

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DXA measures low bone density, a common condition among older people and one that is associated with increased risk for osteoporotic fractures, which in turn are associated with disability, mortality, and significant economic costs.

The survey consisted of questions on the accessibility and quality of DXA services, and was issued to 331 FLS centers, with 124 responding. Data received from 121 centers was deemed suitable for the survey. Each respondent — who together hailed from 31 countries — participated in the Capture the Fracture Best Practice Framework, which provides globally endorsed standards for fracture liaison services.

While more than 70% of services reported DXA access met service needs more than 90% of the time and had excellent scanning and reporting quality, 25% said they were not accredited by a professional or governmental organization. Less than 50% of services confirmed that they adhere to basic DXA quality and reporting procedures, and over 50% stated a desire to receive ongoing education in osteoporosis for DXA machine operators and interpreters.

The study was funded by the International Society for Clinical Densitometry; the International Osteoporosis Foundation; the UK Medical Research Council; and the University of Southampton.

The findings were published in Osteoporosis International.

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