Table 1.
Results related to therapeutic objectives to be established in T2T strategy in osteoporosis
| Question | Wish (%) | Prognosis (%) | ||||
|---|---|---|---|---|---|---|
| A | I | D | A | I | D | |
| For establishing a therapeutic objective, has to be considered | ||||||
| a. patient age | 97.3 | 0.9 | 1.8 | 98.2 | 0.9 | 0.9 |
| b. baseline T-score | 94.6 | 1.8 | 3.6 | 94.6 | 2.7 | 2.7 |
| The therapeutic objective is to be achieved | ||||||
| a. rapidly | 75.0 | 2.7 | 22.3 | 93.4 | 3.8 | 2.8 |
| b. constantly and consistently maintained | 96.4 | 1.8 | 1.8 | 93.8 | 3.6 | 2.7 |
| The following parameters could be used as therapeutic objectives in the context of the T2T strategy in osteoporosis | ||||||
| a. BTM | 86.8 | 3.8 | 9.4 | 60.6 | 10.4 | 29.2 |
| b. BMD | 91.1 | 0.9 | 8.0 | 91.1 | 6.3 | 2.7 |
| c. fracture risk reduction measured FRAX | 75.9 | 8.0 | 16.1 | 84.0 | 6.6 | 9.4 |
| d. absence of new fractures | 99.1 | – | 0.9 | 97.3 | 0.9 | 1.8 |
| The BMD (measured with the T-score) has to be used as the principal parameter for defining an adequate therapeutic objective in the context of the T2T strategy in osteoporosis | 83.0 | 1.8 | 15.2 | 83.9 | 4.5 | 11.6 |
| If BMD is used as the principal parameter for defining an adequate therapeutic objective, it has to be measured using a | ||||||
| a. tangible absolute value | 88.7 | – | 11.3 | 92.5 | 0.9 | 6.6 |
| b. predetermined difference between two values | 85.7 | 7.1 | 7.1 | 82.1 | 12.5 | 5.4 |
| If BMD is used as the principal parameter for defining an adequate therapeutic objective, the target lumbar spine T-score to be achieved is | ||||||
| a. >−2.5 SD | 75.9 | 8.0 | 16.1 | 92.5 | 0.9 | 6.6 |
| b. >−2.0 SD | 64.3 | 13.4 | 22.3 | 53.6 | 24.1 | 22.3 |
| c. >−1.5 SD | 39.9 | 19.6 | 41.1 | 30.4 | 25.9 | 43.8 |
| d. >−1.0 SD | 24.1 | 21.4 | 54.5 | 18.8 | 22.3 | 58.9 |
| e. an increment of 2 SD with reference to the baseline BMD | 81.1 | 3.8 | 15.1 | 83.0 | 3.8 | 13.2 |
| f. an increment in the basal BMD (any change) | 86.8 | 2.8 | 10.4 | 86.8 | 4.7 | 8.5 |
| If BMD is used as the principal parameter for defining an adequate therapeutic objective, the target femoral (femoral neck of total hip) T-score to be achieved is | ||||||
| a. >−2.5 SD | 79.5 | 3.6 | 17.0 | 79.5 | 7.1 | 13.4 |
| b. >−2.0 SD | 77.7 | 7.1 | 15.2 | 93.4 | 1.9 | 4.7 |
| c. >−1.5 SD | 46.4 | 14.3 | 39.3 | 38.4 | 22.3 | 39.3 |
| d. >−1.0 SD | 30.4 | 15.2 | 54.5 | 23.2 | 18.8 | 58.0 |
| e. an increment of 2 SD with reference to the baseline BMD | 84.9 | 4.7 | 10.4 | 84.0 | 3.8 | 12.3 |
| f. an increment in the basal BMD (any change) | 86.8 | 10.4 | 2.8 | 86.8 | 3.8 | 9.4 |
| If fracture risk reduction is used as the principal parameter for defining an adequate therapeutic objective, it has to be measured using | ||||||
| a. FRAX | 85.8 | 2.8 | 11.3 | 87.7 | 4.7 | 7.5 |
| b. Q-fracture | 59.4 | 24.5 | 16.0 | 31.1 | 54.7 | 14.2 |
| c. Garvan | 28.3 | 40.6 | 31.1 | 9.4 | 74.5 | 16.0 |
| If fracture risk reduction is used as the principal parameter for defining an adequate therapeutic objective, it has to be measured using a | ||||||
| a. tangible percentage | 89.6 | 2.8 | 7.5 | 91.5 | 2.8 | 5.7 |
| b. predetermined difference between two values | 86.8 | 4.7 | 8.5 | 87.7 | 5.7 | 6.6 |
| If fracture risk reduction measured by FRAX is used as the principal parameter for defining an adequate therapeutic objective, the risk of major fractures (hip, vertebral, femur, humerus, and radius) has to be lower than | ||||||
| a. 5% | 55.7 | 1.9 | 42.5 | 50.9 | 2.8 | 46.2 |
| b. 7.5% | 72.6 | 2.8 | 24.5 | 63.2 | 5.7 | 31.1 |
| c. 10% | 75.5 | 2.8 | 21.7 | 68.9 | 4.7 | 26.4 |
| d. 20% | 43.4 | 1.9 | 54.7 | 41.5 | 3.8 | 54.7 |
| If the absence of new fractures is used as the principal parameter for defining an adequate therapeutic objective, the incidence of fractures has to be measured using | ||||||
| a. VFA | 83.0 | 10.7 | 6.3 | 92.5 | 0.9 | 6.6 |
| b. height | 75.9 | 8.9 | 15.2 | 94.3 | 2.8 | 2.8 |
| c. conventional X-ray | 88.4 | 5.4 | 6.3 | 83.9 | 8.0 | 8.0 |
| d. major nonvertebral fragility fracture (humerus, radius, and femur) | 96.4 | 2.7 | 0.9 | 95.5 | 2.7 | 1.8 |
| e. any fracture (including pelvic branches and other long bones) | 91.1 | 7.1 | 1.8 | 85.7 | 8.9 | 5.4 |
| BTM are good therapeutic indicators for | ||||||
| a. determining the therapeutic objective | 79.2 | 5.7 | 15.1 | 64.2 | 5.7 | 30.2 |
| b. selecting population to be treated | 29.2 | 5.7 | 65.1 | 21.7 | 5.7 | 72.6 |
| c. establishing a therapeutic strategy | 52.8 | 9.4 | 37.7 | 43.4 | 9.4 | 47.2 |
| d. performing treatment follow-up | 83.9 | 7.1 | 8.9 | 78.6 | 11.6 | 9.8 |
| If BTM are used as the principal parameter for defining an adequate therapeutic objective, they have to be measured using a | ||||||
| a. tangible absolute value | 58.5 | 7.5 | 34.0 | 42.5 | 10.4 | 47.2 |
| b. predetermined difference between two values | 79.5 | 10.7 | 9.8 | 95.3 | 3.8 | 0.9 |
Italic values represent the most answered option
A agreement, I indifference, D disagreement, wish (desire for it to happen), prognosis (belief that it will happen in a 5-year period)