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Comparison of screening strategies for prevalent vertebral fractures in South Korea: vertebral fracture assessment vs. spine radiography

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Authors
Oh, Sung-Hee; Kim, Dam; Lee, Young Eun; Kim, Deog-Yoon; Lee, Yu Kyung; Lee, Joo-Hyun; Bae, Sang-Cheol; Choi, Yun Young; Pyo, Junhee; Ahn, Jeonghoon; Sung, Yoon-Kyoung
Issue Date
2018-02-12
Publisher
BioMed Central
Citation
BMC Musculoskeletal Disorders, 19(1):46
Keywords
Spinal fractureRadiographyDiagnostic imagingCost effectivenessRadiation
Abstract
Background
Vertebral Fracture Assessment (VFA) is a useful tool to detect the vertebral fracture (VF) with low cost and radiation exposure. We aimed to compare screening strategies including VFA and spine radiography (X-ray) for detecting VF in terms of clinical effectiveness, cost and radiation exposure.

Methods
Three screening strategies: 1) X-ray following VFA, 2) VFA only, and 3) X-ray only were compared using a Markov model based on administrative data from South Korea in a population aged ≥50 years. We compared the incidence of new VFs, cost-effectiveness of reducing new VFs and radiation exposure in each strategy.

Results
The incidence of new VFs was reduced in all screening strategies compared to no screening: 29.4% for women and 12.5% for men in both X-ray following the VFA and VFA only strategies and 35% for women and 17.5% for men in the X-ray only strategy. The X-ray following VFA strategy had the lowest cost, followed by the X-ray only, and VFA only strategies. The radiation doses for X-ray only were 2,647–2,989 μSv and 3,253–3,398 μSv higher than in the X-ray following VFA and VFA only strategies. The new VF prevention effect was greater in women, and more prominent in older people (women ≥ 70, men ≥ 80) than people ≥ 50 years.

Conclusions
The X-ray following VFA strategy is a cost-effective option for screening prevalent VF to prevent new VF in people aged ≥50 years due to its high effectiveness, lowest cost, and least radiation exposure.
ISSN
1471-2474
Language
English
URI
http://hdl.handle.net/10371/139585
DOI
https://doi.org/10.1186/s12891-018-1958-1
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Graduate School of Public Health (보건대학원)Dept. of Public Health (보건학과)Journal Papers (저널논문_보건학과)
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