Evidence map›Paper›PMID 42560542›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Trends and disparities in DXA testing for osteoporosis among Medicare beneficiaries, 2005-2023.

Casey E Pelzl, Anand K Narayan, Tyler M Prout, Neil C Binkley, Tarig Elhakim, Taha Lodhi, Alexandra Drake, Elizabeth Y Rula, Eric W Christensen, Dania Daye

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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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Casey E PelzlHarvey L. Neiman Health Policy Institute, 1892 Preston White Dr., Reston, VA, 20191, USA. cpelzl@acr.org.ORCID http://orcid.org/0000-0002-0954-9863
Anand K NarayanDepartment of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
Tyler M ProutDepartment of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
Neil C BinkleyUniversity of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA.
Tarig ElhakimUniversity of Pennsylvania Health System, Philadelphia, PA, USA.
Taha LodhiGeorge Washington University, Washington, D. C., USA.
Alexandra DrakeHarvey L. Neiman Health Policy Institute, 1892 Preston White Dr., Reston, VA, 20191, USA.
Elizabeth Y RulaHarvey L. Neiman Health Policy Institute, 1892 Preston White Dr., Reston, VA, 20191, USA.
Eric W ChristensenHarvey L. Neiman Health Policy Institute, 1892 Preston White Dr., Reston, VA, 20191, USA.
Dania DayeDepartment of Radiology, University of Wisconsin-Madison, Madison, WI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

DXA utilization among Medicare beneficiaries declined 35% from 2005 to 2023. Declines were disproportionately larger among racial/ethnic minorities and socioeconomically deprived groups, while use increased among highest-acuity patients. These findings highlight widening inequities in DXA testing and underscore the need for targeted policy and public health interventions.

objectiveThe objective of this study is to examine the association between demographic and socioeconomic (SES) factors and national trends in dual-energy X-ray absorptiometry (DXA) testing among Medicare beneficiaries.

methodsThis 19-year repeated cross-sectional study used 5% Medicare fee-for-service claims (2005-2023) to assess the annual utilization of DXA. Claims missing patient ZIP code, age, or race/ethnicity were excluded. Patient acuity was measured using the Neiman Imaging Comorbidity Index (NICI). Patient residence ZIP codes were used to determine urbanicity and Area Deprivation Index. Annual DXA utilization was calculated per 100,000 beneficiaries overall and stratified by SES covariates. Covariate associations with DXA utilization were assessed using logistic regression and comparisons of adjusted odds ratios (AOR) between years quantified utilization changes.

resultsWe identified 5,243,098 unique beneficiaries from 2005 to 2023 (mean 2,517,265 beneficiaries per year); 1,218,904 (23.2%) beneficiaries had at least one DXA. Annual use per 100,000 beneficiaries declined 35.4% from 7255 in 2005 to 4,690 in 2023. Hispanic beneficiaries saw the largest percentage decrease (-35.3%) in AOR of DXA utilization from 2005 (AOR, 0.93) to 2023 (AOR, 0.60), while beneficiaries with NICI ≥ 7 demonstrated the largest percentage increase (+57.7%) in AOR of DXA utilization from 2005 (AOR, 1.11) to 2023 (AOR, 1.70).

conclusionsUnderserved populations have seen greater declines in DXA utilization compared with the observed national decline from 2005 to 2023. Future studies should identify the underlying factors associated with these disparities to inform public health interventions that enhance equitable utilization of DXA testing across the nation.

Indexed as

DXAMedicare beneficiariesOsteoporosis

Identifiers

PMID42560542

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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.