Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group.
Level 5 - mechanism / opinion, no new human data
Expert committee report synopsis without systematic review methodology or primary empirical data
PubMed 7696835 · doi:10.1007/BF01622200
What was done
This paper summarizes a World Health Organization (WHO) Study Group report evaluating screening strategies and fracture risk assessment for postmenopausal osteoporosis in Caucasian women, focusing on single- and dual-energy absorptiometry.
What was found
The abstract reports no numerical data. Qualitatively, bone mineral density measurements demonstrate high specificity but lower sensitivity, providing greater diagnostic value in individuals at higher risk. The report notes little evidence that public health policies targeting lifestyle risk factors (smoking, exercise, nutrition) effectively tackle osteoporosis, indicating that selective screening should target high-cost bone-active medications to susceptible women at or after menopause.
Why it matters
It outlines early international consensus criteria from the WHO recommending targeted risk-based screening over universal screening to optimize the cost-effectiveness of bone-modifying therapies.
Limits
The abstract reports no primary clinical trial data, quantitative metrics, or sample size. The recommendations are limited to Caucasian women and reflect 1994 clinical assumptions regarding hormone replacement therapy.
Cited by
- context The diagnostic standards for normal bone density were changed, categorizing millions of people as having osteopenia or osteoporosis.