Анализ эффективности внедрения системы скрининга остеопороза

Abstract

Osteoporosis is defined as a systemic skeletal disease characterized by low mineral bone mass and microarchitectural deterioration of bone tissue. This consequently increases bone fragility and susceptibility to fracture. Osteoporosis affects every third woman and every fourth man over 50 years old. Osteoporosis is a heavy burden for the health care of the Russian Federation, defined as RUB25 billion annually. Up to 31% of women and 4% of men over 50 years of age need special therapy for prevents the destruction of bone tissue. Identification of these risk groups allows early treatment and prevention of pathological fractures. The paper analyzes modern approaches to the diagnosis of osteoporosis. An overview of diagnostic methods is given, including artificial intelligence technologies for recognizing low-energy vertebral fractures, as well as methods of routine dual-energy absorptiometry DXA. CT bone densitometry technic (QCT) are also discussed. The principle of the FRAX tool is presented to identify patients at high risk of low-energy fractures, as well as to determine the groups of patients in need of densitometric studies. Various models of osteoporosis screening are analyzed, with an assessment of their medical and economic efficiency. The economic substantiation of the most effective strategy – conducting a questionnaire on FRAX followed by densitometric studies is presented. This will prevent more than 50% of low energy fractures without increasing costs. These efforts are aimed at increasing quality of life old population. This will contribute to the achievement of the targets set in the national project “Demography”.