BONE-MINERAL DENSITY-MEASUREMENTS - ARE THEY WORTH WHILE

Bone mineral density measurements have been criticized on the grounds that they are not a worth-while screening tool. In this paper we argue that bone mineral measurements can be an efficient diagnostic tool ev en if they are not of proven value for screening. There is complex rel ationship between the costs of a measurement, the intervention and the predictive value of the test all of which must be accounted for when assessing the value of a bone density measurement. For bone density me asurements to be used for screening, a wider evaluation needs to be un dertaken compared with that for their use as a diagnostic tool. We add ress some common objections, for example, that low compliance with scr eening would undermine efficiency, and show that these are not relevan t. Evaluations of screening need to address issues that are likely to affect efficiency.