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Comparison of screening strategies for prevalent vertebral fractures in South Korea: vertebral fracture assessment vs. spine radiography

Title
Comparison of screening strategies for prevalent vertebral fractures in South Korea: vertebral fracture assessment vs. spine radiography
Author
배상철
Keywords
Spinal fracture; Radiography; Diagnostic imaging; Cost effectiveness; RadiationRadiation
Issue Date
2018-02
Publisher
BIOMED CENTRAL LTD
Citation
BMC MUSCULOSKELETAL DISORDERS, v. 19, Article no. 46
Abstract
Background: Vertebral Fracture Assessment (VFA) is a useful tool to detect the vertebral fracture (VF) with low cost and radiation exposure. We aimed to compare screening strategies including VFA and spine radiography (X-ray) for detecting VF in terms of clinical effectiveness, cost and radiation exposure. Methods: Three screening strategies: 1) X-ray following VFA, 2) VFA only, and 3) X-ray only were compared using a Markov model based on administrative data from South Korea in a population aged >= 50 years. We compared the incidence of new VFs, cost-effectiveness of reducing new VFs and radiation exposure in each strategy. Results: The incidence of new VFs was reduced in all screening strategies compared to no screening: 29.4% for women and 12.5% for men in both X-ray following the VFA and VFA only strategies and 35% for women and 17. 5% for men in the X-ray only strategy. The X-ray following VFA strategy had the lowest cost, followed by the X-ray only, and VFA only strategies. The radiation doses for X-ray only were 2,647-2,989 mu Sv and 3,253-3,398 mu Sv higher than in the X-ray following VFA and VFA only strategies. The new VF prevention effect was greater in women, and more prominent in older people (women >= 70, men >= 80) than people >= 50 years. Conclusions: The X-ray following VFA strategy is a cost-effective option for screening prevalent VF to prevent new VF in people aged >= 50 years due to its high effectiveness, lowest cost, and least radiation exposure.
URI
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-018-1958-1https://repository.hanyang.ac.kr/handle/20.500.11754/117591
ISSN
1471-2474
DOI
10.1186/s12891-018-1958-1
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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