AUTHOR=Rühling Sebastian , Schwarting Julian , Froelich Matthias F. , Löffler Maximilian T. , Bodden Jannis , Hernandez Petzsche Moritz R. , Baum Thomas , Wostrack Maria , Aftahy A. Kaywan , Seifert-Klauss Vanadin , Sollmann Nico , Zimmer Claus , Kirschke Jan S. , Tollens Fabian 

TITLE=Cost-effectiveness of opportunistic QCT-based osteoporosis screening for the prediction of incident vertebral fractures

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1222041

DOI=10.3389/fendo.2023.1222041

ISSN=1664-2392

ABSTRACT=Objectives: Opportunistic quantitative computed tomography (oQCT) derived from nondedicated routine CT has demonstrated high accuracy in diagnosing osteoporosis and predicting incident vertebral fractures (VFs). We aimed to investigate the cost-effectiveness of oQCT screening compared to dual-energy X-ray absorptiometry (DXA) as standard of care for osteoporosis screening. Methods: Three screening strategies ("no osteoporosis screening", "oOCT screening", "DXA screening") after routine CT were simulated in a state-transition model for hypothetical cohorts of 1000 patients (women and men, respectively, aged 65 years) over a follow-up period of 5 years (base case). The primary outcomes were the cumulative costs and the quality-adjusted life years (QALYs) estimated from a U.S. health care perspective for the year 2022. Costeffectiveness was assessed based on a willingness-to-pay (WTP) threshold of $70,249 per QALY. The secondary outcome was the number of prevented VFs. Deterministic and probabilistic sensitivity analyses were conducted to test the models' robustness. Results: Compared to DXA screening, oQCT screening increased QALYs in both sexes (additional 2.40 per 1000 women and 1.44 per 1000 men