All of the follow-up tests included a statement of BMD change (wh

All of the follow-up tests included a statement of BMD change (where this change could be calculated). Table 5 Elements from CAR 2005 recommendations   Baseline reports (total = 27) Repeat reports (total = 21) All reports (total = 48) N (%) N (%) N (%) Patient identifiers (name, DOB, sex) 27 (100.0) 21 (100.0) 48 (100.0) Scanner identifier (brand) 13 (48.1) 18 (85.7) 31 (64.6) Raw BMD results (g/cm2) 23 (85.2) 20 (95.2) 43 (89.6) T-scores 27 (100.0) 21 (100.0) 48 (100.0) Diagnosis 26 (96.3) 20 (95.2) 46 (95.8) Selleck Selinexor fracture risk for patients >50 23 (85.2)

17 (81.0) 40 (83.3) Statement of BMD change, where appropriate N/A 20 (100)* N/A Statement of significance, where appropriate N/A 17 (85)* N/A Least significant change for imaged sites N/A 1 (4.8) N/A *1 report could not include a statement of change due to weight gain; % relates to remaining 20 reports Akt inhibitor Elements of reports that were less likely to

be included were scanner identifiers and LSCs detectable by scanners. Approximately 48 % of baseline reports and 85.7 % of repeat reports included some information on the brand of scanners used. Approximately 44 % of baseline and 71.4 % of repeat tests relied on attachments produced by scanning machines to provide this information. Least significant changes for each skeletal site were reported in only one, or 3.7 %, of the 21 repeat exams. Discussion The current study of 48 BMD reports from 27 independent BMD scanning facilities in the province of Ontario aimed to determine accuracy

of 10-year fracture risk assessments present on BMD reports in Ontario as of 2008, as well as overall conformation to CAR’s 2005 published reporting standards. In 2008, there were approximately 150 hospitals in the province that were performing BMD scans (Ontario Ministry of Health and Long-Term Rho Care, 2011, personal communication); our study captures data from reports produced by 19 of these, which is more than 10 % of the total. The main finding of this study was that a minority of both baseline and repeat reports included risk factors, namely previous fracture, in the overall assessment of fracture risk even though all of the patients had had a recent fracture. This led to subsequent inaccuracies in terms of fracture risk assessment with fracture risk being underestimated in more than 50 % of the BMD reports. A strength of this study is that the patients’ history of fragility fracture is based both on records of visits to EDs as well as on interviews with an osteoporosis coordinator. In addition, the study demonstrates that standards for diagnosis published by CAR in 2005 were not regularly employed nor were recommendations for formatting particularly as they related to least significant detectable changes or scanner identification.

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