B2-4: A Vertebral Fracture Assessment (VFA) Performance Algorithm Improves Appropriate Utilization Among Those Referred for Bone Density Tests (DXA).

Background/Aims Densitometric lateral spine imaging (vertebral fracture assessment, or VFA) identifies prevalent vertebral fracture and improves fracture risk estimation, but is under-utilized in clinical practice. We created an algorithm to be used by bone density (DXA) technologists to identify those with moderate or higher pre-test probability of prevalent vertebral fracture who should have VFA at the time of a DXA test. Our objectives were to: a) assess changes of VFA utilization after implementation of the algorithm at a large rural multispecialty community health care organization and an academic health center; and b) assess the association of VFA results with prescription of fracture prevention medication.