Recommendation by	Year	BMD measurement recommended for	Recommend method	Frequency
Ontario Osteoporosis Strategy (178)	2003	Ontario Guidelines for the Prevention and Treatment of Osteoporosis does not address BMD testing. Ontario Health Insurance Plan	DXA at the hip and/or spine	Annual for people at high-risk of osteoporosis and once every 2 years for people at low risk
Canadian Task Force on Preventive Health Care (44)	2004	Postmenopausal women (Grade B) who (a) are ≥ 65 yrs old (b) <60 kg (c) have history of previous fracture, (d) have an ORAL score ≥9, or (e) have a score ≥6 on the SCORE questionnaire (grade B) Insufficient evidence to recommend using bone turnover markers to predict fracture	Use SCORE questionnaire or ORAL instrument to predict low BMD (grade A) BMD screening using DEXA to prevent fractures in post menopausal women with a risk factor (Grade I)	-
Osteoporosis Canada (Former Osteoporosis Society of Canada) (45)	2002	BMD measurement for men or women age >65 (Grade A) -Targeted case-finding for those with increased risk (1 major or 2 minor)* adults age 50 – 65 yrs –	Hip or spine DXA the most accurate tool. Access to BMD measurement should not be limited by decision tools based on clinical risk factors (Grade A) Quantitative ultrasound may be considered for diagnosis of osteoporosis but not for follow-up at this time. Bone turnover markers should not yet be used for routine clinical management.	-Monitor using central DXA in 1–2 years after initiating therapy -monitor height loss with thoracolumbar spine X-ray
Manitoba (179)	2000	Manitoba Bone Density Program Targeted testing for: -Vertebral or nonvertebral fragility fractures proven by x-ray. -Osteopenia or osteoporosis proven by x-ray -Systemic corticosteroid therapy>3 months/year -Prolonged amenorrhea prior to age 45 years if results needed to decide on hormonal or drug therapy -Women>age 65 years if results needed to decide on hormonal or drug therapy		Follow-up of previous BMD (initial recommended interval 3 years for most patients, 1 year for patients on systemic corticosteroid therapy
BC Health Services (43)	2005	BMD measurement should only be performed when: The results are likely to alter patient care AND Patients have at least 1 major or 2 minor risks factors* for osteoporosis (age ≥65 a major risk factor)	DXA Risk factors same as those identified by Osteoporosis Canada. Did not recommend screening for women <65 or as part of routine evaluation around the time of menopause.	Follow-up BMD measurements not considered necessary prior to 2 yrs after previous measurement except in people on high dose of prednisone for >/= 3 months or with existing fractures with very low bone density
US Preventive Service Task Force (180)	2002	-Women ≥ 65 years -Women ≥ 60 years & at increased risk for osteoporosis -Postmenopausal women <60 or between 60–64 yrs not at increased risk: no recommendation for or against screening	Number needed to screen to prevent 1 hip fracture in 5 years = approximately 1,000 or less
International Society for Clinical Densitometry 2004 (18)	2004	-Women≥ 65 years- Postmenopausal women <65 yrs with risk factors -Men ≥ 70 yrs -Adults with fragility fracture or disease associated with low bone mass or bone loss. -Adults taking medication associated with low bone mass or bone loss -People receiving treatment or in whom evidence of bone loss would lead to treatment	DXA @ posterior-anterior spine & hip & @ forearm if spine or hip not feasible.