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Bone Densitometry and Treatment for Osteoporosis in Older Men
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To the Editor: In their cost-effective analysis of screening bone densitometry followed by alendronate therapy for older men diagnosed with osteoporosis, Dr Schousboe and colleagues1 conclude that mass screening may be cost-effective for men aged 65 years or older with a prior clinical fracture and for men aged 80 to 85 years without a prior fracture. However, the Markov model used in their analysis does not consider functional status to define the base-case population and the health states.
Studies have shown marked heterogeneity in patients with hip fracture based on their pre- and post-fracture functional status.2 The pre-fracture functional status of patients with hip fractures is often poorer than that of the general population. For example, a cohort study conducted among persons residing in Rochester, Minnesota, reported that 28% of incident hip fractures occurred in individuals already living in a nursing home.3 It is likely that the absolute difference in . . . [Full Text of this Article]
Kouta Ito, MD
koi2001@med.cornell.edu
Division of General Internal Medicine
Weill Cornell Medical College of Cornell University
New York, New York
RELATED LETTER
Bone Densitometry and Treatment for Osteoporosis in Older Men—Reply
John T. Schousboe, Brent C. Taylor, Howard A. Fink, Douglas C. Bauer, Robert L. Kane, and Kristine E. Ensrud
JAMA. 2007;298(18):2137.
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RELATED ARTICLE
Cost-effectiveness of Bone Densitometry Followed by Treatment of Osteoporosis in Older Men
John T. Schousboe, Brent C. Taylor, Howard A. Fink, Robert L. Kane, Steven R. Cummings, Eric S. Orwoll, L. Joseph Melton, III, Douglas C. Bauer, and Kristine E. Ensrud
JAMA. 2007;298(6):629-637.
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