The following is a summary of “National Survey of the Bone Densitometry Evaluation Process within an Integrated Healthcare System,” published in the December 2023 issue of Rheumatology by Steffen et al.

This study was designed to comprehensively evaluate the status of Bone Mineral Density (BMD) evaluation services using dual-energy X-ray absorptiometry (DXA) in Veterans within the framework of the Veterans Health Administration (VHA). To achieve this objective, a national Bone Densitometry Survey was meticulously developed by a specialized Work Group composed of experts well-versed in bone densitometry practices. This survey underwent multiple iterations of drafting and revisions to ensure its accuracy and relevance. Subsequently, the study finalized was distributed via the REDCap platform and disseminated via email to designated contacts at 178 VHA facilities nationwide. The response rate to the survey was 31%, with 56 out of 178 facilities providing valuable insights.

The survey results shed light on several positive practices among DXA centers within the VHA. A majority of the surveyed centers reported utilizing DXA machines that were less than a decade old (63%), were in “excellent” or “good” condition according to internal assessments (78%), and conducted regular phantom calibrations to ensure equipment accuracy (77%). Furthermore, a notable portion of facilities (73%) implemented intake processes proven to minimize errors in DXA assessments. However, the survey also revealed areas warranting improvement. While many centers provided specialized training for DXA technologists (66%), only a quarter of them (25%) received accredited training. Moreover, routine precision assessments, a critical component for quality control in DXA evaluations, were conducted by only 30% of the facilities.

While indicating several positive practices adhering to minimal standards, these findings also underscored discrepancies and the absence of standardized practices across the integrated healthcare system. The study emphasizes the importance of enhancing quality control measures to ensure consistent and high-quality BMD assessments for Veterans within the VHA. Efforts to standardize and improve DXA practices could significantly enhance the precision and reliability of bone health evaluations for this population.

Source: sciencedirect.com/science/article/abs/pii/S1094695023001099