Elsevier

Journal of Clinical Densitometry

Volume 16, Issue 4, October–December 2013, Pages 455-466
Journal of Clinical Densitometry

2013 Position Development Conference on Bone Densitometry
Executive Summary of the 2013 International Society for Clinical Densitometry Position Development Conference on Bone Densitometry

https://doi.org/10.1016/j.jocd.2013.08.004Get rights and content

Abstract

The International Society for Clinical Densitometry (ISCD) convenes a Position Development Conference (PDC) every 2–3 yr to make recommendations for guidelines and standards in the field of musculoskeletal measurement and assessment. The recommendations pertain to clinically relevant issues regarding the acquisition, quality control, interpretation, and reporting of various aspects of musculoskeletal health metrics. Topics for consideration are developed by the ISCD Board of Directors and the Scientific Advisory Committee. For the 2013 PDC, body composition analysis was a central topic area for the first time and considered timely because of the scientific advances in measurement of fat and lean body mass by dual-energy X-ray absorptiometry (DXA). Indications for DXA and vertebral fracture assessment and use of reference data to calculate bone mineral density T-scores were also updated. Task Forces for each of these areas were assigned questions of relevance to a clinical audience and asked to conduct comprehensive literature reviews. Reports with proposed Position Statements were then presented to an international panel of experts. The Expert Panel included representatives of the International Osteoporosis Foundation, the American Society for Bone and Mineral Research, the National Osteoporosis Foundation, Osteoporosis Canada, and the North American Menopause Society. The PDC was held in Tampa, FL, contemporaneously with the Annual Meeting of the ISCD, March 21 through March 23, 2013. This report describes the methodology of the 2013 ISCD PDC and summarizes the results of the 2013 ISCD PDC for vertebral fracture assessment/DXA and National Health and Nutrition Survey (NHANES) Reference Database Task Forces. A separate article in this issue will summarize the results of the Body Composition Analysis Task Forces.

Introduction

The International Society for Clinical Densitometry (ISCD) is a nonprofit professional organization dedicated to the advancement of assessment of musculoskeletal health, particularly (but not limited to) bone densitometry. A major focus of the Society is the development of guidelines and establishment of standards for bone densitometry, assessment of fracture risk, and other aspects of musculoskeletal measurement. The Society conducts Position Development Conferences (PDCs) every 2–3 yr to develop guidelines and standards (expressed as Position Statements) for new technologies used to assess musculoskeletal health and fracture risk and to update older guidelines and standards as new data become available. The ISCD Official Positions are widely used by clinicians and densitometry technologists as a reference regarding the indications for, acquisition of, and interpretation and reporting of measures of musculoskeletal health and incorporation of those measures into fracture risk assessment. The curricula of the densitometry educational courses provided by ISCD are largely based on these Positions.

The ISCD PDC process is designed to summarize and use the best scientific evidence available to develop and update Position Statements regarding musculoskeletal assessment. Because musculoskeletal assessment technologies are evolving, clinically important issues are sometimes addressed in the absence of robust evidence and are, thus, largely based on expert opinion. However, the PDC process grades and highlights the limitations of the available evidence pertinent to each Statement and indicates where additional research is needed to improve the scientific evidence on which Positions are based and to resolve areas of ambiguity and controversy.

Position Statements from prior PDCs held in 2001, 2003, 2005, 2007, and 2010 have been published 1, 2, 3, 4, 5, 6. The most recent PDC was held in Tampa, FL, March 21 through March 23, 2013. This article describes the methodology of this PDC and the results from the topics regarding indications for bone densitometry, indications for vertebral fracture assessment (VFA), and use of young reference databases to calculate bone densitometry T-score values. A subsequent article in this issue reports the results of the PDC regarding the indications for, acquisition of, and interpretation and reporting of body composition analysis studies using dual-energy X-ray absorptiometry (DXA).

Section snippets

Methodology

Potential topics for the 2013 ISCD PDC were solicited from the ISCD Board of Directors (BOD), Executive Committee, and members of the Scientific Advisory Committee. Candidate topics were then ranked in order of importance. Body composition analysis was nearly unanimously identified as a critically new application of DXA requiring new guidelines and standards. Three other topical areas in which the ISCD already has Official Positions (1) were chosen to be updated because of new data that had

Acknowledgments

As was true of prior PDCs, the 2013 ISCD PDC was possible only through the extensive voluntary efforts of large numbers of individuals, notably the clinical and scientific experts who donated countless hours over the past 18 mo as Task Force chairs, Task Force members, or Expert Panel members. The ISCD wishes to acknowledge and thank these individuals for their extraordinary service. Additionally, the staff of ISCD plays a crucial role organizing the logistics and infrastructure of these

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