Evidence map›Paper›PMID 29520605›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

Opportunistic screening for bone disease using abdominal CT scans obtained for other reasons in newly diagnosed IBD patients.

D Rebello, D Anjelly, D J Grand, J T Machan, M D Beland, M S Furman, J Shapiro, N LeLeiko, B E Sands, M Mallette and 4 more

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 1 country.

D RebelloAlpert Medical School, Brown University, Providence, RI, USA. Dionne.rebello@lifespan.org.
D AnjellyAlpert Medical School, Brown University, Providence, RI, USA.
D J GrandAlpert Medical School, Brown University, Providence, RI, USA.
J T MachanDepartment of Biostatistics and Research, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
M D BelandAlpert Medical School, Brown University, Providence, RI, USA.
M S FurmanAlpert Medical School, Brown University, Providence, RI, USA.
J ShapiroAlpert Medical School, Brown University, Providence, RI, USA.
N LeLeikoAlpert Medical School, Brown University, Providence, RI, USA.
B E SandsThe Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
M MalletteDivision of Gastroenterology, Rhode Island Hospital, Providence, RI, USA.
R BrightDivision of Gastroenterology, Rhode Island Hospital, Providence, RI, USA.
H MonizDivision of Gastroenterology, Rhode Island Hospital, Providence, RI, USA.
M MerrickCrohn's & Colitis Foundation, New York, NY, USA.
S A ShahAlpert Medical School, Brown University, Providence, RI, USA.
Rhode Island Hospital · USBrown University · USProvidence College · USHasbro Children's Hospital · USCrohn's and Colitis Foundation · USIcahn School of Medicine at Mount Sinai · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bone disease is prevalent among patients with inflammatory bowel disease (IBD), though bone density screening remains underutilized. We used CT scans performed for other indications in IBD patients to identify and monitor osteopenia using CT attenuation values at the lumbar spine. Significant rates of bone disease were detected which would have otherwise gone undiagnosed.

introductionOsteoporosis affects about 14-42% of patients with IBD. Though screening is recommended in IBD patients with risk factors, it remains underutilized. In patients with newly diagnosed IBD, we used CT scans performed for other indications to identify and monitor progression of osteopenia.

methodsUsing the Ocean State Crohn's and Colitis Area Registry, we identified adult patients with one or more abdominal CT scans. Each patient had two age- and gender-matched controls. Radiologists measured attenuation through trabecular bone in the L1 vertebral body recorded in Hounsfield units (HU). Generalized estimating equations were used to measure how HU varied as a function of gender, type of IBD, and age.

resultsOne hundred five IBD patients were included, and 72.4% were classified as "normal" bone mineral density (BMD) and 27.6% as potentially osteopenic: 8.6% with ulcerative colitis and 19.0% with Crohn's disease. We found a decrease in bone density over time (p < 0.001) and that BMD decreases more in Crohn's disease than in ulcerative colitis (p < 0.004). Sixty patients had two CT scans, and mean loss of 9.3 HU was noted. There was a non-significant decrease in BMD over time in patients exposed to > 31 days of steroids and BMD was stable with < 30 days of steroid exposure (p < 0.09).

conclusionUsing CT scans obtained for other indications, we found low rates of osteopenia and osteoporosis that may otherwise have gone undiagnosed. Refinement of opportunistic screening may have advantages in terms of cost-savings and earlier detection of bone loss.

Indexed as

AdolescentAdultAgedAged, 80 and overBone DensityBone Diseases, MetabolicEarly DiagnosisFemaleFollow-Up StudiesGlucocorticoidsHumansIncidenceInflammatory Bowel DiseasesLumbar VertebraeMaleMass ScreeningGlucocorticoidsCrohn’s diseaseInflammatory bowel diseaseMontreal classificationOsteoporosisUlcerative colitis

Identifiers

PMID29520605
OpenAlexW2791802460

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.