Head, shoulders, skin and bones….

On the first three, The Globe’s Alex Beam has fun with BU’s renegade dermatologist , who seems to have created a road show out of his 15-minutes-of-sun advice.

On bones, the US Preventative Services Task Force is now recommending that all postmenopausal women WITH RISK FACTORS for osteoporosis be screened for the disease.

Currently, many women get bone scans at menopause and begin drugs based on the scans alone. Some say that behavior is widespread and leads to over-treatment. Still, the scan-and-treat approach has been promoted by the makers of blockbuster bone loss drugs.

At the same time, some researchers say that many women who need treatment for bone loss never get diagnosed.

The USPSTF suggests that risk – as measured by simple test called the Fracture Risk Assessment Tool — should trigger the scan.

The USPSTF used the FRAX model (http://www.shef.ac.uk/FRAX/) to estimate 10-year risks of fractures because: 1) this prediction tool relies on easily obtainable clinical information (e.g., age, body mass index, parental fracture history, tobacco and alcohol use), 2) its development was supported by a broad international collaboration and extensively validated in two large U.S. cohorts, and 3) it is freely accessible by clinicians and the public.

More on FRAX here. If the risk is high, then scan.

The draft recommendations are now open for comment for a month.

Note that the World Health Organization does not endorse screening for women under 65: Indirect evidence supports screening women ≥65 years, but no direct evidence supports widespread screening programs using BMD testing.


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