Journal of Clinical Densitometry
Volume 10, Issue 4 , Pages 365-369, October 2007

A New Approach for Quantifying Change and Test Precision in Bone Densitometry

  • William D. Leslie

      Affiliations

    • University of Manitoba, Winnipeg, Manitoba, Canada
    • Corresponding Author InformationAddress correspondence to: Dr. William D. Leslie, MD, MSc, Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.
    • ,
  • Alireza Moayyeri

      Affiliations

    • Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
    • ,
  • Mohsen Sadatsafavi

      Affiliations

    • Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, British Columbia, Canada
    • ,
  • Liqun Wang

      Affiliations

    • University of Manitoba, Winnipeg, Manitoba, Canada

Received 5 July 2007; received in revised form 6 August 2007; accepted 6 August 2007. published online 21 September 2007.

Abstract 

The effect of precision study sample size is not considered in current recommendations for assessing bone mineral density (BMD) change. Intuitively, a larger sample size should provide greater confidence in the derived least significant change (LSC), which should translate into a more confident determination of change. We evaluated an empirical Monte Carlo simulation method for estimating the significance of an observed change in BMD that simultaneously considers the magnitude of the change, the LSC point estimate, and the precision study sample size. This method showed a progressive increase in the ability to identify BMD change using larger precision study sample sizes. Approaches that consider the error in the LSC estimate may provide more robust determinations of BMD change even when the precision study sample size is limited.

Key Words: Bone densitometry, dual-energy x-ray absorptiometry, osteoporosis, precision, sample size

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PII: S1094-6950(07)00206-5

doi:10.1016/j.jocd.2007.08.002

Journal of Clinical Densitometry
Volume 10, Issue 4 , Pages 365-369, October 2007

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