{"doi":"10.3389/fendo.2023.1222041","title":"Cost-effectiveness of opportunistic QCT-based osteoporosis screening for the prediction of incident vertebral fractures","abstract":"Objectives: Opportunistic quantitative computed tomography (oQCT) derived from non-dedicated routine CT has demonstrated high accuracy in diagnosing osteoporosis and predicting incident vertebral fractures (VFs). We aimed to investigate the cost-effectiveness of oQCT screening compared to dual-energy X-ray absorptiometry (DXA) as the standard of care for osteoporosis screening. Methods: Three screening strategies (\"no osteoporosis screening\", \"oQCT screening\", and \"DXA screening\") after routine CT were simulated in a state-transition model for hypothetical cohorts of 1,000 patients (women and men aged 65 years) over a follow-up period of 5 years (base case). The primary outcomes were the cumulative costs and the quality-adjusted life years (QALYs) estimated from a U.S. health care perspective for the year 2022. Cost-effectiveness was assessed based on a willingness-to-pay (WTP) threshold of $70,249 per QALY. The secondary outcome was the number of prevented VFs. Deterministic and probabilistic sensitivity analyses were conducted to test the models' robustness. Results: Compared to DXA screening, oQCT screening increased QALYs in both sexes (additional 2.40 per 1,000 women and 1.44 per 1,000 men) and resulted in total costs of $3,199,016 and $950,359 vs. $3,262,934 and $933,077 for women and men, respectively. As a secondary outcome, oQCT screening prevented 2.6 and 2.0 additional VFs per 1,000 women and men, respectively. In the probabilistic sensitivity analysis, oQCT screening remained cost-effective in 88.3% (women) and 90.0% (men) of iterations. Conclusion: oQCT screening is a cost-effective ancillary approach for osteoporosis screening and has the potential to prevent a substantial number of VFs if considered in daily clinical practice.","journal":"Frontiers in Endocrinology","year":2023,"id":334729,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9444,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1063567,"name":"Julian Schwarting","orcid":"0000-0003-0616-5706","position":1,"is_corresponding":false},{"id":1063568,"name":"Matthias F. Froelich","orcid":"0000-0001-8501-2147","position":2,"is_corresponding":false},{"id":1063569,"name":"Maximilian T. Löffler","orcid":"0000-0002-6022-3682","position":3,"is_corresponding":false},{"id":327083,"name":"Jannis Bodden","orcid":"0000-0001-5997-203X","position":4,"is_corresponding":false},{"id":1063570,"name":"Moritz Roman Hernández Petzsche","orcid":"0000-0002-4288-3863","position":5,"is_corresponding":false},{"id":1063571,"name":"Thomas Baum","orcid":"0000-0002-4574-5212","position":6,"is_corresponding":false},{"id":1063572,"name":"Maria Wostrack","orcid":"0000-0001-6439-3665","position":7,"is_corresponding":false},{"id":1063573,"name":"Amir Kaywan Aftahy","orcid":"0000-0002-8897-2220","position":8,"is_corresponding":false},{"id":1063574,"name":"Vanadin Seifert‐Klauss","orcid":"0000-0002-2639-5317","position":9,"is_corresponding":false},{"id":274932,"name":"Nico Sollmann","orcid":"0000-0002-8120-2223","position":10,"is_corresponding":false},{"id":465684,"name":"Claus Zimmer","orcid":"0000-0002-4805-9103","position":11,"is_corresponding":false},{"id":775911,"name":"Jan S. Kirschke","orcid":"0000-0002-7557-0003","position":12,"is_corresponding":false},{"id":1063575,"name":"Fabian Tollens","orcid":"0000-0002-2340-1785","position":13,"is_corresponding":false},{"id":1063566,"name":"Sebastian Rühling","orcid":"0000-0002-9518-7810","position":0,"is_corresponding":true}],"reference_count":60,"raw_metadata":null,"created_at":"2026-07-19T01:09:53.742667Z","pmid":"37576975","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}