Rules of Interpretation

BoneStation is a web-based reporting system for DXA based bone densitometry. In many of our blog posts we mention that BoneStation requires no transcription and no dictation. That is because BoneStation automatically generates a suggested assessment.

What is meant by that? How does it work?

BoneStation combines three inputs:

  • DXA Scan Data – The bone mineral data from the DXA scan
  • Patient Data – Information about the patient
  • Questionnaire – Online questionnaire that is built into BoneStation

The scan data, patient info, and questionnaire answers are fed into a rules engine. The engine output the assessment text, which is displayed to the reading physician as a suggested assessment. The reading physician can accept the assessment or alter it.

A simple set of rules may look like this, where the T-score and Z-score are the lowest values for all measured sites:

The above rules make use of information that is available from just the DXA scans (T-score and Z-score) and patient (age). One common variation on this set of rules is to incorporate the gender and menopausal status of women. The rules can be adjusted to look like this, where the menopausal status is indicated on the questionnaire.

BoneStation is very flexible. The questionnaire, rules, and (output) assessment text are all customizable. Some BoneStation customers’ rules consist of more than 30 rules when factoring in fractures (VFA) and other patient conditions.

Here are some sample questionnaires:

In our next blog post we’ll look at how fractures and VFA can be factored into the above rules.

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