Understanding Osteoporosis Screening Practices in Men: A Nationwide Physician Survey.
Understanding Osteoporosis Screening Practices in Men: A Nationwide Physician Survey.
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DOI：
10.4158/ep-2020-0123
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Papaleontiou M
中科院分区：
文献类型：
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作者：
Choksi P;Gay BL;Reyes-Gastelum D;Haymart MR;Papaleontiou M
了解骨质疏松症筛查实践，特别是男性，由不同的医生队列，包括初级保健医生，内分泌学家和老年病医生。我们随机调查了美国家庭实践学会(AAFP)、内分泌学会和美国老年医学学会的成员。受访者被要求通过订购骨密度扫描来评估他们在四种不同的临床场景中筛查骨质疏松症的频率。多变量Logistic回归分析被用来确定在每种临床情况下对男性进行骨质疏松症筛查的相关因素。医生还被要求注意导致男性骨质疏松症筛查的因素。有效率为63%(359/566)。虽然90%的受访者表示，他们会一直或经常对65岁的绝经后女性进行骨质疏松症筛查，但只有22%的受访者表示，他们会对74岁的男性进行筛查，这些男性过去没有明显的病史。与初级保健医生相比，内分泌科医生更有可能筛查74岁的男性[优势比(OR)2.32，95%可信区间(CI)1.10-4.88]。除了长期使用类固醇(94%)、非创伤性骨折史(88%)和前列腺癌雄激素剥夺疗法(82%)外，超过一半的医生报告说，抑制剂量的甲状腺激素(%)和跌倒史(52%)是导致男性骨质疏松筛查的因素。我们的调查结果突出了男性骨质疏松症筛查的异质性，与女性相比，在某些情况下筛查不足，并确定了导致男性筛查的因素。这些发现有助于设计干预措施，以改善男性骨质疏松症的筛查。
To understand osteoporosis screening practices, particularly in men, by a diverse cohort of physicians, including primary care physicians, endocrinologists and geriatricians. We surveyed randomly selected members of the American Academy of Family Practice (AAFP), Endocrine Society and American Geriatrics Society. Respondents were asked to rate how often they would screen for osteoporosis in four different clinical scenarios by ordering a bone density scan. Multivariable logistic regression analyses were conducted to determine factors associated with offering osteoporosis screening in men in each clinical scenario. Physicians were also asked to note factors that would lead to osteoporosis screening in men. Response rate was 63% (359/566). While 90% respondents reported that they would always or frequently screen for osteoporosis in a 65-year old postmenopausal woman, only 22% reported they would screen a 74-year-old man with no significant past medical history. Endocrinologists were more likely to screen a 74-year-old man compared to primary care physicians [odds ratio (OR) 2.32, 95% confidence interval (CI) 1.10–4.88]. In addition to chronic steroid use (94%), history of non-traumatic fractures (88%) and androgen-deprivation therapy for prostate cancer (82%), more than half the physicians reported suppressive doses of thyroid hormone (64%) and history of falls (52%) as factors leading to screening for osteoporosis in men. Our survey results highlight heterogeneity in osteoporosis screening in men, with underscreening in some scenarios compared to women, and identifies factors that lead to screening in men. These findings can help design interventions to improve osteoporosis screening in men.