International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions
Introduction
The International Society for Clinical Densitometry (ISCD) is a professional society composed of clinicians, scientists, and technologists dedicated to enhancing knowledge and improving quality in the assessment of skeletal health. The ISCD strives to accomplish this mission through venues that include educational events, the Journal of Clinical Densitometry, certification in bone densitometry, and the establishment of standards and guidelines (Official Positions). New and updated Official Positions have been developed every two years since 2001 at Position Development Conferences (PDCs). The Official Positions provide a reference standard for quality control, acquisition, analysis, interpretation, and reporting of bone density tests. They have advanced the field of bone densitometry by improving the quality and consistency of bone density testing, and have focused attention on topics in need of further study.
The findings of the 2001, 2003, and 2005 PDCs have been published in the Journal of Clinical Densitometry [1], [2], [3] in association with publications providing supporting evidence, the rationale, and controversies, if any, for each Official Position. In 2007, separate adult and pediatric PDCs were held. The Adult PDC was on July 20–22, 2007, in Lansdowne, Virginia; the Pediatric PDC was June 20–21, 2007, in Montreal, Quebec, Canada. This is a review of the 2007 PDC methodology, key participants (Appendices), selected Official Positions for adults, and the complete Official Positions for children and adolescents. Executive summaries, listings of all participants, and supporting evidence are published in the Journal of Clinical Densitometry [4], [5]. All ISCD Official Positions may be viewed and downloaded online at http://www.iscd.org.
Section snippets
Methodology
Topics for the 2007 PDC were selected according to clinical relevancy, a perceived need for standardization, and the likelihood of the expert panelists achieving agreement. Each topic area was assigned a set of clinical questions. Thereafter, an ISCD task force evaluated the medical evidence using a modification of the Cochrane review method [6]. Literature searches were conducted with electronic databases that included PubMed, EMBASE and MEDLINE. Appropriate articles were selected from the
Official Positions of the ISCD
Listed are selected ISCD Official Positions, with those that are new in bold.
General recommendations for non-central DXA devices: QCT, pQCT, QUS, and pDXA
The following general recommendations for QCT, pQCT, QUS, and pDXA are analogous to those defined for central DXA technologies. Examples of technical differences amongst devices, fracture prediction ability for current manufacturers and equivalence study requirements are provided in the full text documents printed in the Journal of Clinical Densitometry.
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Bone density measurements from different devices cannot be directly compared.
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Different devices should be independently validated for fracture
Fracture prediction and definition of osteoporosis
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Fracture prediction should primarily identify children at risk of clinically significant fractures, such as fracture of long bones in the lower extremities, vertebral compression fractures, or two or more long-bone fractures of the upper extremities.
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The diagnosis of osteoporosis in children and adolescents should NOT be made on the basis of densitometric criteria alone.
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The diagnosis of osteoporosis requires the presence of both a clinically significant fracture history and low bone mass.
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A
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Official positions of the International Society for Clinical Densitometry and executive summary of the 2007 position development conference
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Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 Pediatric Position Development Conference
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