GHP April 2017

16 GHP / April 2017 , 1704GH06 Bindex ® , Osteoporosis Diagnosis is now Reliable, Fast and Easy Osteoporosis is a condition that causes bones to become thin and porous, decreasing bone strength and leading to increased risk of fracture. The annual resultant costs in treating these preventable fractures is huge, about €40 billion in the EU and £2 billion in the UK alone. In England, every year hip fractures alone account for: • nearly 69,000 unplanned hospital admissions • 1.3 million hospital bed days • approximately £1.5 billion in hospital costs • plus the resulting ongoing high cost of social care Osteoporosis is an extremely underdiagnosed disease; of an estimated 200 million osteoporosis sufferers globally, only 25% have been diagnosed with the disease meaning that 75% go undiagnosed and may never receive treatment. The current gold-standard method for diagnosing osteoporosis is Dual Energy X-ray Absorptiometry, what’s known as a DXA or DEXA scan, performed with DXA (X-ray) devices; an expensive process which requires a referral to a central hospital where the scanners are located, and trained radiographers in attendance. Osteoporosis is acknowledged around the globe as a major health issue and one that is only going to get worse with an ageing population. This is evidenced by the introduction of a Fracture Liaison Service (FLS) in many countries to ensure that patients presenting with non-trauma fractures have their bone structure evaluated and are provided with a care plan to maintain bone health in order to prevent future broken bones. However, what is really needed is an easier, cheaper method of diagnosing osteoporosis earlier in order to reduce the number of initial fractures; making diagnosis available to the masses in primary care instead of only available to the minority via referral. Bindex ® is the world’s first pocket-sized, research-proven tool for osteoporosis screening and diagnostics and was developed under the direction of Dr. Ossi Riekkinen, a medical physicist and co-founder of a Finnish start-up, Bone Index. Dr. Riekkinen has personal experience of the devastating effect undiagnosed osteoporosis can have. His mother-in-law is in her mid-80s; she is still very active mentally, but she can hardly move due to several fractures in her spine. She suffered two or three fractures before being referred for a bone density measurement where osteoporosis was eventually diagnosed - but of course the damage had already been done by this time. Bindex ® was created to cover this early diagnosis gap; it has been validated according to international guidelines, and its measurements are thus comparable to standard diagnostic procedures (axial DXA, X-ray device). The process does not cause an ionizing radiation dose, can be used without a physician referral unlike X-ray-based methods (DXA), and generates a measurement of the cortical thickness of the tibia. By using the thickness information along with other data such as the age, weight and height of the patient, a Density Index value is determined. Density Index value is an estimation for the hip region’s bone mineral density (g/cm2) which is normally only measured via the large DXA devices used in hospitals. The Bindex ® method has been validated with DXA in clinical studies and 90% sensitivity and specificity thresholds for osteoporosis have been determined for Density Index; medics may therefore use Bindex ® results as reliable criteria in diagnosis and treatment (National Osteoporosis Society (NOS) guideline for peripheral DXA devices - NOS document NOS 00202 “Peripheral X-ray absorptiometry in the management of osteoporosis” available here) . The Density Index values are indicated in a colour bar (green/ yellow/red) and the thresholds are used to discriminate the colours. The sensitivity and specificity thresholds mean that 90% of osteoporotic patients will receive either yellow or red result during a Bindex ® measurement, whereas 90% of non-osteoporotic patients will receive either green or yellow result. Only 30% of patients under osteoporosis suspicion will receive a yellow result and therefore need additional investigations with DXA. The 90% accuracy is a significant result in comparison to any medical measurement method in that it follows the International Society for Clinical Densitometry’s (ISCD) guidelines. In the UK, Bindex ® was exhibited at the recent National Osteoporosis Conference 2016, the UK’s leading conference on osteoporosis, and a number of demonstration scans performed on visitors. One of those scanned