Statistical Challenges in the Analyses of Bone Mineral Density in Pediatric Populations

This article highlights several potential problems in the calculation of the Z-score: (1) reference data are manufacturer dependent; (2) a transformation is recommended to reduce the skewness often seen in BMD data, however a transformation parameter is only available in some references using the Hologic manufacturer; (3) some reference data may be obsolete, as they were done under older scan models; (4) reference data are recommended to be interpolated to the subject’s age, and linear interpolation is questionable; (5) reference data do not exist for all age groups; (6) reference data depend on the race of the subjects, and not all races are representative; and (7) reference data are limited to certain body composition. Given the limitation in the BMD Z-scores, other clinical symptoms (eg, bone fractures) or laboratory findings (eg, bone biomarkers) should be assessed in conjunction with the BMD Z-score to evaluate a subject’s bone health.
Source: Therapeutic Innovation and Regulatory Science - Category: Drugs & Pharmacology Authors: Tags: Special Populations Source Type: research