Construction and validation of a population-based bone densitometry database

Leslie, William D.<sup>1,2</sup>; Caetano, Patricia A.<sup>3</sup>; MacWilliam, Leonard R.<sup>2</sup>; Finlayson, Gregory S.<sup>2</sup>

Affiliations

¹Departments of Medicine and Radiology, St. Boniface General Hospital, Winnipeg, Canada

²Manitoba Center for Health Policy, Faculty of Medicine, University of Manitoba, Winnipeg, Canada

³Faculty of Pharmacy, University of Manitoba, Winnipeg, Canada

Abstract and keywords

Utilization of dual-energy X-ray absorptiometry (DXA) for the initial diagnostic assessment of osteoporosis and in monitoring treatment has risen dramatically in recent years. Population-based studies of the impact of DXA and osteoporosis remain challenging because of incomplete and fragmented test data that exist in most regions. Our aim was to create and assess completeness of a database of all clinical DXA services and test results for the province of Manitoba, Canada and to present descriptive data resulting from testing. A regionally based bone density program for the province of Manitoba, Canada was established in 1997. Subsequent DXA services were prospectively captured in a program database. This database was retrospectively populated with earlier DXA results dating back to 1990 (the year that the first DXA scanner was installed) by integrating multiple data sources. A random chart audit was performed to assess completeness and accuracy of this dataset. For comparison, testing rates determined from the DXA database were compared with physician administrative claims data. There was a high level of completeness of this database (>99%) and accurate personal identifier information sufficient for linkage with other health care administrative data (>99%). This contrasted with physician billing data that were found to be markedly incomplete. Descriptive data provide a profile of individuals receiving DXA and their test results. In conclusion, the Manitoba bone density database has great potential as a resource for clinical and health policy research because it is population based with a high level of completeness and accuracy.

Keywords: Osteoporosis; bone densitometry; health services

Links

DOI: 10.1385/JCD:8:1:025

PubMed: 15722584

WoS: 000227538200005

History

Received: 2004-08-3

Revised: 2004-09-22

Accepted: 2004-09-22

Cited Works (1)

Year	Entry
2002	Cummings SR, Bates D, Black DM. Clinical use of bone densitometry: scientific review. JAMA. October 16, 2002;288(15):1889-1897.

Cited By (22)

Year	Entry
2021	Schousboe JT, Lix LM, Morin SN, Leslie WD. Associations of clinically recognized vs unrecognized vertebral fracture with mortality. Bone. April 2021;145:115868.
2021	Monchka BA, Kimelman D, Lix LM, Leslie WD. Feasibility of a generalized convolutional neural network for automated identification of vertebral compression fractures: the Manitoba Bone Mineral Density Registry. Bone. September 2021;150:116017.
2022	Schousboe JT, Morin SN, Kline GA, Lix LM, Leslie WD. Differential risk of fracture attributable to type 2 diabetes mellitus according to skeletal site. Bone. January 2022;154:116220.
2022	Monchka BA, Schousboe JT, Davidson MJ, Kimelman D, Hans D, Raina P, Leslie WD. Development of a manufacturer-independent convolutional neural network for the automated identification of vertebral compression fractures in vertebral fracture assessment images using active learning. Bone. August 1, 2022;161:116427.
2022	Hafizi S, Lix LM, Hans D, Bolton JM, Leslie WD. Association of mental disorders and psychotropic medications with bone texture as measured with trabecular bone score. Bone. December 2022;165:116565.
2010	Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA; Manitoba Bone Density Program. Independent clinical validation of a Canadian FRAX tool: fracture prediction and model calibration. J Bone Miner Res. November 2010;25(11):2350-2358.
2011	Hans D, Goertzen AL, Krieg M-A, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res. November 2011;26(11):2762-2769.
2012	Giangregorio LM, Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA. FRAX underestimates fracture risk in patients with diabetes. J Bone Miner Res. February 2012;27(2):301-308.
2022	Leslie WD, Morin SN, Lix LM, McCloskey EV, Johansson H, Harvey NC, Kanis JA. The effect of fracture recency on observed 10-year fracture probability: a registry-based cohort study. J Bone Miner Res. May 2022;37(5):848-855.
2022	Leslie WD, Morin SN, Lix LM, McCloskey EV, Johansson H, Harvey NC, Kanis JA. Effect of discordant hip bone density on incident fracture risk: a registry-based cohort study. J Bone Miner Res. October 2022;37(10):2018-2024.
2023	Leslie WD, Goel H, Binkley N, McCloskey EV, Hans D. Contributions of clinical and technical factors to longitudinal change in trabecular bone score and bone density: a registry-based individual-level analysis. J Bone Miner Res. April 2023;38(4):512-521.
2023	Kline GA, Morin SN, Lix LM, Leslie WD. A population-based registry study of extended bisphosphonate use: minimal shift after landmark publications about shorter treatment duration. J Bone Miner Res. October 2023;38(10):1435-1442.
2023	Leslie WD; ASBMR Task Force on Clinical Algorithms for Fracture Risk. Effect of race/ethnicity on United States FRAX calculations and treatment qualification: a registry-based study. J Bone Miner Res. December 2023;38(12):1742-1748.
2023	Leslie WD, Binkley N, Schousboe JT, McCloskey EV, Johansson H, Harvey NC, Kanis JA. Effect of BMI-discordant abdominal tissue thickness on fracture probability: a registry-based study. J Bone Miner Res. December 2023;38(12):1749-1756.
2020	Leslie WD, Schousboe JT, Morin SN, Martineau P, Lix LM, Johansson H, McCloskey EV, Harvey NC, Kanis JA. Fracture risk following high-trauma versus low-trauma fracture: a registry-based cohort study. Osteoporos Int. June 2020;31(6):1059-1067.
2020	Leslie WD, Schousboe JT, Morin SN, Martineau P, Lix LM, Johansson H, McCloskey EV, Harvey NC, Kanis JA. Measured height loss predicts incident clinical fractures independently from FRAX: a registry-based cohort study. Osteoporos Int. June 2020;31(6):1079-1087.
2020	Ng BC, Leslie WD, Johnson KM, FitzGerald JM, Sadatsafavi M, Chen W. Effects of long-term inhaled corticosteroid treatment on fragility fractures in older women: the Manitoba BMD registry study. Osteoporos Int. June 2020;31(6):1155-1162.
2020	Leslie WD, Morin SN, Lix LM, Binkley N. Targeted bone density testing for optimizing fracture prevention in Canada. Osteoporos Int. July 2020;31(7):1291-1297.
2020	Binkley N, Morin SN, Martineau P, Lix LM, Hans D, Leslie WD. Frequency of normal bone measurement in postmenopausal women with fracture: a registry-based cohort study. Osteoporos Int. December 2020;31(12):2337-2344.
2021	Duerksen DR, Lix LM, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Leslie WD. Fracture risk assessment in celiac disease: a registry-based cohort study. Osteoporos Int. January 2021;32(1):93-99.
2021	Leslie WD, Morin SN, Lix LM, McCloskey EV, Johansson H, Harvey NC, Kanis JA. Fracture prediction from FRAX for Canadian ethnic groups: a registry-based cohort study. Osteoporos Int. January 2021;32(1):113-122.
2021	Leslie WD, Edwards B, Al-Azazi S, Yan L, Lix LM, Czaykowski P, Singh H. Cancer patients with fractures are rarely assessed or treated for osteoporosis: a population-based study. Osteoporos Int. February 2021;32(2):333-341.