A systematic review 1 was abstracted in DARE. There have been no scientific trials to assess the effectiveness of population bone screening. The predictive power of bone density screening is low. The effectiveness of hormone replacement therapy in preventing fractures in women with low bone density in the long term is unproven. It is estimated that a bone screening programme may lead to the prevention of no more than 5% of fractures in elderly women.
According to another systematic review 2 abstracted in DARE based on systematic reviews undertaken by health technology assessment agencies and other relevant reviews, 393 women would need to be invited for screening and 197 actually attend in order to avoid one fracture. The overall impact of the programme would be to reduce the number of fractures over the remaining lifetime by 1.7%. When all scenarios are considered, such programmes might prevent between 1% and 7% of fractures.
According to a Swedish systematic review 3, there is no scientific evidence to support the use of bone density measurement as a screening method in healthy, middle-aged individuals. However, bone density measurement plays an important role in examining individuals with multiple risk factors to predict their fracture risk and initiate preventive interventions.
Comment: The quality of evidence is downgraded by limitations in review methodology.
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