ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1996

Variation in Dual-energy X-ray Absorptiometry Reporting: A National Survey of Veterans Health Administration Clinics

Karla Miller1, Melissa Steffen2, Kimberly McCoy2, Michelle Mengeling2, Heather Davila2, Shylo Wardyn2 and Samantha Solimeo2, 1University of Utah School of Medicine, Salt Lake City, UT, 2Department of Veterans Affairs, Iowa City VA HCS, Iowa City, IA

Meeting: ACR Convergence 2023

Keywords: Bone density, Dual energy x-ray absorptiometry (DEXA), osteoporosis, quality of care, risk assessment

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, November 14, 2023

Title: (1996–2018) Osteoporosis & Metabolic Bone Disease – Basic & Clinical Science Poster

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Dual-energy x-ray absorptiometry (DXA) is an important tool to identify Veterans with osteoporosis, assess fracture risk, and monitor treatment response. Variability in DXA acquisition, analysis, interpretation, and reporting is common despite existing best practice guidelines, and can adversely impact the information communicated to the ordering provider. The purpose of this quality improvement study was to evaluate the processes for national VA DXA reporting. This project was part of a larger evaluation to understand access to and quality of DXA services in the VA.

Methods: A work group of radiologists, nuclear medicine physicians, social scientists, endocrinologists, and rheumatologists were convened to develop a national bone densitometry survey. Through an iterative process, the group drafted domains, then identified topics and developed questions for each domain. The DXA reporting domain evaluated information typically included on DXA reports received by the ordering VA provider and time spent creating the reports. This study was reviewed by the Iowa City VA Research and Development Office. Survey invitations were emailed to personnel involved in DXA acquisition and interpretation at 178 facilities. Staff were given 60 days to complete the survey.

Results: Fifty-six of 178 sites (31%) completed information on data elements included in a standard DXA report. Most reports provided information on age (n=43,77%), DXA manufacturer and model (n=39,70%), and indication for DXA (n=37, 66%), while few routinely reported study limitations (n=28,50%), acquisition errors (n=22,39%), menopausal status (n=18,32%), and relevant medications (n=17,30%).DXA report elements used in clinical decision-making varied with most sites reporting T-scores at all measured sites (n=46,82%), impression (n=46,82%), bone mineral density (BMD) in g/cm2 (n=43,77%), and FRAX® (n=38,68%).Some sites reported Z-scores (n=34,61%), percent change in BMD on repeat DXA (n=31,55%), and least significant change (n=22,39%), while few reported trabecular bone score (n=11,20%), lowest T-score only (n=11,20%), and Osteoporosis Self-assessment Tool scores (n=9,16%).Few sites provided guiding recommendations beyond the DXA impression such as considering medications to reduce bone loss (n=7,13%), evaluation for secondary causes of osteoporosis (n=9,16%), or when to repeat DXA (n=11,20%).Nearly a third of sites (n=16,29%) indicated that DXA reports requires a “good amount” or “a lot” of time to prepare.

Conclusion: There is significant variability in the degree to which DXA facilities follow best practice standards for DXA reports, even in an integrated healthcare system. Most VA DXA reports include basic information for clinical decision-making, but many do not routinely provide elements important to interpretation of the report and clinical care guidance. Many DXA sites report substantial effort is needed by diagnosticians to prepare DXA reports. This study uses self-reported data and is limited by number of respondents. Our results will be used to facilitate improvement in DXA reporting quality across radiology and specialty care services in the VA.

Supporting image 1

Information Routinely Included on DXA Reports (n=56)

Supporting image 2

Information Routinely Included on DXA Reports

Supporting image 3

Perceived Effort Associated with Preparing a DXA Report


Disclosures: K. Miller: None; M. Steffen: None; K. McCoy: None; M. Mengeling: None; H. Davila: None; S. Wardyn: None; S. Solimeo: None.

To cite this abstract in AMA style:

Miller K, Steffen M, McCoy K, Mengeling M, Davila H, Wardyn S, Solimeo S. Variation in Dual-energy X-ray Absorptiometry Reporting: A National Survey of Veterans Health Administration Clinics [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/variation-in-dual-energy-x-ray-absorptiometry-reporting-a-national-survey-of-veterans-health-administration-clinics/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2023

ACR Meeting Abstracts - https://acrabstracts.org/abstract/variation-in-dual-energy-x-ray-absorptiometry-reporting-a-national-survey-of-veterans-health-administration-clinics/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology