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WOMEN'S HEALTH

Comparison of the Achilles Express Ultrasonometer with Central Dual-Energy X-Ray Absorptiometry

Associate Professor, Albany College of Pharmacy; Adjunct Assistant Professor, Albany Medical College, Albany, NY

Jennifer Cerulli, PharmD BCPS

Associate Professor, Albany College of Pharmacy

Jeffrey S Stroup, PharmD BCPS

at time of writing, Resident, Albany College of Pharmacy; now, Clinical Assistant Professor, College of Pharmacy, University of Oklahoma, Norman, OK

Michael P Kane, PharmD FCCP BCPS

Associate Professor, Albany College of Pharmacy; Clinical Pharmacy Specialist, The Endocrine Group, LLP, Albany

Reprints: Dr. Grabe, Department of Pharmacy Practice, Albany College of Pharmacy, 106 New Scotland Ave., Albany, NY 12208-3425, fax 518/694-9018, grabed{at}acp.edu

BACKGROUND: Quantitative ultrasound (QUS) devices provide portable, easy-to-operate, low-cost options for point-of-care screening of bone mineral density (BMD). Community pharmacists should be aware of the precision, sensitivity, and specificity of these devices prior to their purchase.

OBJECTIVE: To determine the precision, sensitivity, and specificity of the Achilles Express ultrasonometer compared with central dual-energy X-ray absorptiometry (cDXA) as well as its utility as a bone density screening device in the community pharmacy setting.

METHODS: A prospective study in a community pharmacy and outpatient ambulatory clinic was conducted with 2 groups of white women. Group 1 participants were 25-35 years of age (young, healthy), and those in Group 2 were 45 years of age or older (postmenopausal). BMD assessments of the spine and the nondominant wrist and hip were performed using cDXA. Assessments of the heel were performed using the Achilles Express, a QUS device. The main outcome measures were correlation of t-scores between cDXA and QUS measurements using the Pearson correlation test.

RESULTS: Twenty-two (30 ± 4 years of age) and 31 (55 ± 17 years of age) women were enrolled into Groups 1 and 2, respectively. Significant correlations between QUS and hip and spine cDXA t-scores were found in both groups. Correlation coefficients for QUS versus hip cDXA were 0.51 (95% CI 0.11 to 0.77) and 0.70 (95% CI 0.46 to 0.85) in Groups 1 and 2, respectively. Correlation coefficients for the QUS versus spine cDXA were 0.64 (95% CI 0.31 to 0.84) and 0.60 (95% CI 0.31 to 0.79) in Groups 1 and 2, respectively. The QUS device has a sensitivity level of 88% and specificity of 71% to detect a hip cDXA t-score of less than-1.

CONCLUSIONS: The Achilles Express ultrasonometer is a reasonable screening tool to detect low BMD in postmenopausal women.

Key Words: bone mineral density, DXA, osteoporosis, quantitative ultrasound, screening tool

Published Online, May 2, 2006. www.theannals.com, DOI 10.1345/aph.1G549