Hi Nathji, that is a very interesting article, but also a bit disheartening.  I don't necessarily agree with the whole thing, but I do think that treatment decisions shouldn't always be based on a dxa score that is done every 12 months, or on a scan result that only shows minor improvement or no change in t-score. 

My insurance won't let me have a dxa scan more than every 24 months unless it's considered medically necessary, and many Dr.'s have told me that bone density increases take a long time.  Of course they don't say how long but long non the less.

It will be interesting to hear what the National Osteoporosis Foundation has to say about this and also the ISCD (International Society of Clinical Densitometry) since it contradicts the recommendations of both societies.  I'm also wondering if it has anything to do with the fact that one of the medical institutions involved is located in a country with a National Health System, where there are many more checks and balances on what the system agrees to pay for or not, and how often given the affect this type of spending could have on that system.

In the US Medicare is facing dxa spending cuts, and those who are over 65 may be looking at having to pay more out-of-pocket for dxa's if the cuts are approved.

The bill before Congress is the "Medicare Fracture Prevention and Osteoporosis Testing Act of 2009," and I do hope that the cuts don't take affect and we need to ask Congress to reverse dxa reimbursement cuts and protect patient access to osteoporosis testing. 

We need more ways to evaluate bone quality and quantity and until something else comes along dxa is all we have.  You can have bone marker tests, but I understand they may not be available all over the world.  I have that test in addition to a dxa, but if it's not available to all then dxa is what's left.

Sorry I probably wasn't much help, but this stumped me too when I first read it and wondered why I wasn't hearing more about it, and frankly I don't know what to make of it.

Let us know what you think...

nathji

7/ 9/09 10:44pm

Dear Pam,

 

It is always nice to see you here and as active in helping people as ever! Please see the discussion that I initiated on this topic which I posted here as well:

 

http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/sos-on-bone-density-measurements-june-24-2009/

 

In India they dont have Medical Health Insurance of the sort you have in the US-- so patients have to pay from their pockets and private doctors may hay while the sun shines. In fact there are doctors who specialise in "diseases of the rich". One has only to see the opulent style of their living and the mansions they reside in to understand this, and the huge expensive cars that they drive, usually chauffeur driven. The fact that there are lots of fat and rich patients adds to their grandeur. 

 

It would be wonderful if someone could discover a simple way for measuring fracture rick maybe from some blood tests. But I dont think that is a possibility in the near future. Please read the discussion on NOF and post some of your studied advice there as well.

 

Hope you are well.

 

Thanks a lot again,

Yours,

Priya