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Screening for Osteoporosis in Men: A Clinical Practice Guideline from the American College of Physicians
- Amir Qaseem, MD, PhD, MHA;
- Vincenza Snow, MD;
- Paul Shekelle, MD, PhD;
- Robert Hopkins, Jr., MD;
- Mary Ann Forciea, MD;
- Douglas K. Owens, MD, MS; and
- for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians*
- From the American College of Physicians and University of Pennsylvania, Philadelphia, Pennsylvania; University of Arkansas, Little Rock, Arkansas; Veterans Affairs Greater Los Angeles Healthcare System and RAND, Santa Monica, California; and Veterans Affairs Palo Alto Health Care System and Stanford University, Stanford, California.
Abstract
Description: The American College of Physicians developed this guideline to present the available evidence on risk factors and screening tests for osteoporosis in men.
Methods: Published literature on this topic was identified by using MEDLINE (1990 to July 2007). Reference mining was done on the retrieved articles, references of previous reviews, and solicited articles from experts. The inclusion criteria for the studies were measuring risk factors for low bone mineral density or osteoporotic fracture in men or comparing 2 different methods of assessment for the presence of osteoporosis in men. This guideline grades the evidence and recommendations by using the American College of Physicians' clinical practice guidelines grading system.
Recommendation 1: The American College of Physicians recommends that clinicians periodically perform individualized assessment of risk factors for osteoporosis in older men (Grade: strong recommendation; moderate-quality evidence).
Recommendation 2: The American College of Physicians recommends that clinicians obtain dual-energy x-ray absorptiometry for men who are at increased risk for osteoporosis and are candidates for drug therapy (Grade: strong recommendation; moderate-quality evidence).
Recommendation 3: The American College of Physicians recommends further research to evaluate osteoporosis screening tests in men.
Article and Author Information
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Note: Clinical practice guidelines are “guides” only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' judgment. All ACP clinical practice guidelines are considered automatically withdrawn or invalid 5 years after publication, or once an update has been issued.
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Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
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Financial Support: Financial support for the development of this guideline comes exclusively from the American College of Physicians' operating budget.
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Potential Financial Conflicts of Interest: Grants received: V. Snow (Centers for Disease Control and Prevention, Atlantic Philanthropies, United Health Foundation, Bristol-Myers Squibb, Novo Nordisk, Endopharm, Boehringer Ingelheim, Sanofi Pasteur). Any conflict of interest of the Guideline Development Committee group members was declared, discussed, and resolved.
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Requests for Single Reprints: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, aqaseem{at}acponline.org.
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Current Author Addresses: Drs. Qaseem and Snow: 190 N. Independence Mall West, Philadelphia, PA 19106.
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Dr. Shekelle: 1776 Main Street, Santa Monica, CA 90401.
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Dr. Hopkins: 4301 West Markham Street, Little Rock, AR 72205.
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Dr. Forciea: 3615 Chestnut Street, Philadelphia, PA 19104.
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Dr. Owens: 117 Encina Commons, Stanford, CA 94305.
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↵* This paper, written by Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Paul Shekelle, MD, PhD; Robert Hopkins Jr., MD; Mary Ann Forciea, MD; and Douglas K. Owens, MD, MS, was developed for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP): Douglas K. Owens, MD, MS (Chair); Donald E. Casey Jr., MD, MPH, MBA; Paul Dallas, MD; Thomas D. Denberg, MD, PhD; Mary Ann Forciea, MD; Lakshmi Halasyamani, MD; Robert H. Hopkins Jr., MD; William Rodriguez-Cintron, MD; and Paul Shekelle, MD, PhD. Approved by the ACP Board of Regents on 13 January 2008.
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