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The U.S. Preventive Services Task Force guidelines recommend initial screening for osteoporosis in women at age 65 and in younger women whose fracture risk equals that of a 65-year-old woman (Ann Intern Med 2011; 154:356). To determine the most cost-effective approach to screening, researchers ran simulations of several screening strategies, including dual energy x-ray absorptiometry (DXA); calcaneal quantitative ultrasonography (QUS) followed by DXA if T-score was –1.0 or less; and a clinical risk assessment instrument, the Simple Calculated Osteoporosis Risk Estimation (SCORE) tool, followed by DXA if risk was elevated. Simulations also included different initiation ages and follow-up intervals.
Calculations showed that quality-adjusted li…