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A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men

Title
A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men
Authors
Lee, J. -H.Lee, Y. K.Oh, S. -H.Ahn, J.Lee, Y. E.Pyo, J. H.Choi, Y. Y.Kim, D.Bae, S. -C.Sung, Y. -K.Kim, D. -Y.
Ewha Authors
안정훈
SCOPUS Author ID
안정훈scopus
Issue Date
2016
Journal Title
OSTEOPOROSIS INTERNATIONAL
ISSN
0937-941XJCR Link

1433-2965JCR Link
Citation
OSTEOPOROSIS INTERNATIONAL vol. 27, no. 5, pp. 1691 - 1699
Keywords
OsteoporosisSystematic reviewVertebral fracture (VF)Vertebral fracture assessment (VFA)
Publisher
SPRINGER LONDON LTD
Indexed
SCIE; SCOPUS WOS
Document Type
Review
Abstract
This systematic review was performed to compare the diagnostic accuracy of vertebral fracture assessment (VFA) with that of spinal radiography for identification of vertebral fractures (VFs). VFA appeared to have moderate sensitivity and high specificity for detecting VFs when compared with spinal radiography. VFs are recognized as the hallmark of osteoporosis, and a previous VF increases the risk of a future fracture. Therefore, the timely detection of VFs is important for prevention of further fractures. This systematic review examined the diagnostic accuracy of VFA using dual X-ray absorptiometry (DXA) to identify VFs. We searched for potentially relevant studies using electronic databases, including Ovid-Medline, Ovid-EMBASE, Cochrane library, and four Korean databases, from their inception to May 2013. We compared the diagnostic accuracy of VFA with that of spinal radiography for detection of VFs by analyzing the sensitivity and specificity using a 2 x 2 contingency table. Subgroup analyses were also performed on studies with a low risk of bias and applicability. Twelve studies were analyzed for the diagnostic accuracy of VFA. The sensitivity and specificity were 0.70-0.93 and 0.95-1.00, respectively, analyzed on a per-vertebra basis, and 0.65-1.00 and 0.74-1.00 on a per-patient basis. The sensitivity and specificity of five studies in subgroups with a low risk of bias in the intervention test were 0.70-0.84 and 0.96-0.99, respectively. In studies with a low risk of bias in the patient selection, those based on a per-vertebra basis in three studies were 0.70-0.93 and 0.96-1.00, respectively. VFA had moderate sensitivity and high specificity for detecting VF when compared with spinal radiography. However, the present findings are insufficient to assess whether spinal radiography should be replaced by VFA.
DOI
10.1007/s00198-015-3436-z
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신산업융합대학 > 융합보건학과 > Journal papers
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