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Bone Densitometry: Patients with Asymptomatic Primary Hyperparathyroidism

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Title: Bone Densitometry: Patients with Asymptomatic Primary Hyperparathyroidism.

Agency: Agency for Health Care Policy and Research/Center for Health Care Technology (formerly the Office of Health Technology Assessment).

Contact: Martin Erlichman, M.S., and Thomas V. Holohan, M.D., FACP.

Status: Technology Assessment: Published, 1996.

Language: English

Primary Objective: To assess which techniques, if any, are clinically useful in the medical management of patients with bone loss due to asymptomatic primary hyperparathyroidism.

Methods Used: Review of published literature, collection of information from interested public in response to a Federal Register notice of intent to undertake assessment, solicitation of data from other agencies of the U.S. Public Health Service (PHS).

Data Identification: Published literature identified by search of the MEDLINE database, references from bibliographies of reviewed articles, data submitted by other Federal agencies.

Study Selection: All published material of primary data addressing bone loss in patients with PHPT, fracture risk in patients with PHPT and changes in BMD following surgery for PHPT.

Data Extraction: Type of study, size of sample, method and site of measurement, fracture site, bone loss measured and fracture prevalence compared to controls and effectiveness of surgery (increase in BMD).

Key Findings: There is insufficient evidence to conclude that parathyroid-hormone-related bone loss is associated with an increased risk of fracture. Bone-mass measurements cannot predict who among asymptomatic patients will require parathyroidectomy.

Conclusion: Routine use of bone densitometry in patients with asymptomatic primary hyperparathyroidism is not recommended.

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