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Identification of vertebral fractures in Fracture Liaison Services (FLS) in the UK
Poster Title: Identification of vertebral fractures in Fracture Liaison Services (FLS) in the UK
Submitted on 03 Sep 2018
Author(s): Jo Sayer
Affiliations: National Osteoporosis Society
This poster was presented at BIR Annual congress 2018
Poster Views: 922
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Poster Information
Abstract: Identification of vertebral fractures in Fracture Liaison Services (FLS) in the UK


Fracture Liaison Services (FLS) prevent secondary fractures through systematic identification of fragility fractures using case finding, with assessment and treatment of osteoporosis where necessary. Services are measured for quality against the National Osteoporosis Society (NOS) Clinical Standards for FLS. Standard 1 asserts that all patients over 50 with a newly reported vertebral fracture will be systematically and proactively identified. This analysis sought to establish to what extent this standard is being met in the UK.


A rolling gap analysis of FLS provision for identification of vertebral fractures in patients aged over 50 was undertaken. This measured service provision against the national standard.

Data was collected at 110 sites across the UK between 2014 and 2018.


77% (85) of sites had no systematic process in place to identify vertebral fractures. Only 8% (9) sites identified all newly reported vertebral fractures. 15% (16) had procedures in place to identify some vertebral fractures, i.e. within certain cohorts. There was considerable disparity across the UK. Sites in Scotland were significantly more likely to have comprehensive processes in place (38%, 6/16) than in the rest of the UK (3%, 3/94).


Gap analysis shows a lack of systematic identification of vertebral fractures. Responsibility for vertebral fracture identification in secondary care falls across a range of departments, which poses a challenge to clinicians. The NOS published clinical guidance in 2017 that recommends that Radiology departments identify vertebral fractures, report them unambiguously, and alert referring clinicians to the need for onward management or referral to FLS.
Summary: Vertebral fracture identification by Fracture Liaison Services in the UK - the results of a rolling gap analysis, discussion of the under-identification of vertebral fractures and the pivotal role of Radiology. Report abuse »
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