Your Donations in Action: Soterios Gyftopoulos, MD, MBA

Osteoporosis affects more than 50 million adults aged 50 and over in the U.S. Although most osteoporosis studies have focused on non-Hispanic white women, epidemiological findings show that Asian women and men have the highest age-adjusted prevalence of osteoporosis in the U.S.

The term “Asian” encompasses a large, diverse population comprising more than 20 ethnic groups. The U.S. Census Bureau projects that this population, the nation’s fastest-growing racial group, will reach 46 million by 2060.

Because of the serious consequences of osteoporosis-related fractures, screening is an important tool for identifying patients at increased risk and supporting timely prevention through medication, lifestyle changes and other interventions.

Bone densitometry (DXA) remains the imaging modality of choice for assessing fracture risk, but use of DXA remains low across all populations.

For his 2023 RSNA Emerging Issues Grant project, “Understanding and Improving Osteoporosis Screening in U.S. Asian Populations: A Mixed Method Analysis Based Education Initiative,” Soterios Gyftopoulos, MD, MBA, professor of radiology and orthopedic surgery and vice chair of hospital operations in the Department of Radiology at NYU Langone Health in New York City, sought to better understand the current state of osteoporosis screening, with a focus on Asian Americans.

Dr. Gyftopoulos collaborated with co-investigators Connie Y. Chang, MD, MBA, associate professor of radiology at Massachusetts General Hospital, Harvard Medical School, Boston, and Simona C. Kwon, DrPH, MPH, professor of population health and vice chair for department engagement, development and culture in the Department of Population Health at NYU Langone.

Using Medicare claims data from 2015 to 2020, the team performed a retrospective analysis of DXA screening among eligible women aged 65 and older and men aged 70 and older. Among 80,439 eligible Asian American Medicare beneficiaries, only 15.1% received osteoporosis screening. Screening rates were approximately four times higher for women than for men, at 19.8% compared to 5%.

A qualitative analysis that involved semi-structured interviews with physicians at NYU Langone Health who routinely order DXA imaging revealed systemic barriers to screening. These included competing clinical demands, lack of electronic health record prompts and limited staff support for follow-up and scheduling. Patient-level barriers included limited awareness of osteoporosis, low prioritization of screening and fear of treatment complications.

“Understanding the current state of osteoporosis screening rates, including the barriers and facilitators that impact them, allows us to identify opportunities for improvement that we can apply to our clinical practice,” Dr. Gyftopoulos said.

The R&E Foundation grant helped establish a basis for continued research into strategies that may improve earlier diagnosis and treatment for patients with osteoporosis.

“Our findings helped create a foundation of work that will hopefully improve the lives of those with osteoporosis by increasing the likelihood of earlier diagnosis and treatment administration, which will help prevent the potentially devastating complications that can occur as a result of this condition,” Dr. Gyftopoulos said.

For More Information

Learn more about R&E Foundation funding opportunities.

Read our previous Your Donations in Action story.