Short Contents | Full Contents Other books @ NCBI


Surgeon General Reports, SAMHSA TIPs, SAMHSA PEPs AHCPR Archived Technology Assessments

Bone Densitometry: Patients with Asymptomatic Primary Hyperparathyroidism

Health Technology Assessment:

Number 6

U.S. Department of Health and Human Services Public Health Service Agency for Health Care Policy and Research Rockville, Maryland

December 1995

AHCPR Pub. No. 96-0004

View the Medline Citation and Related Citations using PubMed

Abstract

Bone mass loss and osteoporosis are caused by various conditions, such as asymptomatic primary hyperparathyroidism (APHPT), and treatments, such as prolonged steroid therapy. Bone densitometry is used to measure bone mass density to determine the degree of osteoporosis and fracture risk. Bone densitometers measure the radiation absorption by the skeleton to determine bone mass of the peripheral, axial, and total skeleton. Common techniques include single-photon absorptiometry (SPA) of the forearm and heel, dual-photon (DPA) and dual-energy x-ray absorptiometry (DXA) of the spine and hip, quantitative computed tomography (QCT) of the spine or forearm, and radiographic absorptiometry (RA) of the hand. Part I of this report addresses important technical considerations of bone densitometers, including radiation dose, site selection, and accuracy and precision, as well as cost and charges. Part II evaluates the clinical utility of bone densitometry in the management of patients with mild primary hyperparathyroidism. Primary hyperparathyroidism (PHPT) is a generalized disorder of calcium, phosphate, and bone metabolism due to excessive secretion of parathyroid hormone from the parathyroid gland(s). Issues addressed are the type and extent of bone loss in these patients, whether they have an increased risk for fracture, and whether parathyroidectomy reduces the risk of fracture. Subsequent assessments address the clinical utility of bone densitometry for steroid-dependent patients, estrogen-deficient women, patients with vertebral abnormalities, and end-stage renal disease patients.top link

Foreword

The Center for Health Care Technology (CHCT) evaluates the risks, benefits, and clinical effectiveness of new or unestablished medical technologies. In most instances, assessments address technologies that are being reviewed for purposes of coverage by federally funded health programs.

CHCT's assessment process includes a comprehensive review of the medical literature and emphasizes broad and open participation from within and outside the Federal Government. A range of expert advice is obtained by widely publicizing the plans for conducting the assessment through publication of an announcement in the Federal Register and solicitation of input from Federal agencies, medical specialty societies, insurers, and manufacturers. The involvement of these experts helps ensure inclusion of the experienced and varying viewpoints needed to round out the data derived from individual scientific studies in the medical literature.

CHCT analyzed and synthesized data and information received from experts and the scientific literature. The results are reported in this assessment. Each assessment represents a detailed analysis of the risks, clinical effectiveness, and uses of new or unestablished medical technologies. If an assessment has been prepared to form the basis for a coverage decision by a federally financed health care program, it serves as the Public Health Service's recommendation to that program and is disseminated widely.

CHCT is one component of the Agency for Health Care Policy and Research (AHCPR), Public Health Service, Department of Health and Human Services.

Thomas V. Holohan, M.D., FACP, Director, Center for Health Care Technology
Clifton R. Gaus, Sc.D., Administrator, Agency for Health Care Policy and Research


Questions regarding this assessment should be directed to:
Center for Health Care Technology
AHCPR
Willco Building, Suite 309
6000 Executive Boulevard
Rockville, MD 20852
Telephone: (301) 594-4023
top link


Copyright and Disclaimer