Analysis of ISCD-NIST Survey for Bone Health

In 2007, the National Institute of Standards and Technology and the International Society for Clinical Densitometry designed a survey to prioritize 7 research and standardization action items to improve accuracy and cross-comparability of dual-energy X-ray absorptiometry (DXA) measurements of bone mineral density. In this article, we analyze the 1074 survey responses as one means to define consensus priorities of the community studying bone health and to determine possible correlations between prioritization and demographic data, including geographic location, years of experience practicing DXA, and medical specialty. We find that the distribution of ranks from all respondents is such that we can conclude with statistical confidence that there are perceived distinctions between the relative merits of the 7 action items. Applying a standard vote-counting rule to the data, we determine a complete ranking of the action items. We observe that a consistent ranking of each action item across all demographic subcategories is hard to achieve. When we arrange the 7 action items into 4 groups, however, we can determine a reasonably consistent prioritization. The group containing the development of standard reference databases and phantoms receives the highest priority. In addition, we report consistent themes that emerge from the free-response portion of the survey.