Abendroth K, Geidel H, Leube K, Poetzschner R, Schröder H E, Völz B
Z Arztl Fortbild Qualitatssich. 1999 Oct;93(8):605-11.
The Regional Advisory Board Osteoporosis (REKO) for Saxony-Thuringia has established interdisciplinary quality circles in different districts with the goal to standardize the diagnosis of osteoporosis. Therefore, they developed a standardized program for general practitioners, gynecologists, internists and orthopedics. The documentation sheet covers 5 areas: Identification of the anamnestic osteoporosis risk with 7 standardized questions: If the patient reaches 3 or more out of 13 possible points, we assume he is at risk. 3 out of 5 clinical symptoms, 3 out of 6 x-ray symptoms and osteoporosis typical results of the bone density measurement in combination with the anamnesis give us a scale which allows us to classify each symptom for diagnostic purpose. The differential diagnostic laboratory program includes: Blood sedimentation rate, calcium, alkaline phosphatase, creatine, TSH basal and 25 OH vitamin D3 in the serum. To check effectiveness of the antiresorptive therapy, bone specific resorption markers are sometimes usable. The program will be implemented this year in all quality circles, evaluated and then defined in its final form. Among the participants of the quality circles, the program is already usable and offers a reliable basis for the therapy.
萨克森 - 图林根州骨质疏松区域咨询委员会(REKO)在不同地区建立了跨学科质量圈,目标是规范骨质疏松症的诊断。因此,他们为全科医生、妇科医生、内科医生和骨科医生制定了一个标准化项目。文档表涵盖5个领域:通过7个标准化问题识别既往骨质疏松风险:如果患者在13个可能的分数中达到3分或更多,我们认为他处于风险中。5种临床症状中的3种、6种X射线症状中的3种以及骨密度测量的骨质疏松典型结果与既往史相结合,为我们提供了一个量表,使我们能够为诊断目的对每种症状进行分类。鉴别诊断实验室项目包括:血清中的血沉、钙、碱性磷酸酶、肌酸、基础促甲状腺激素和25 - 羟基维生素D3。为了检查抗吸收治疗的效果,有时可使用骨特异性吸收标志物。该项目将于今年在所有质量圈中实施、评估,然后确定其最终形式。在质量圈的参与者中,该项目已经可以使用,并为治疗提供了可靠的基础。