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© 1986 Oxford University Press

research-article

TIMING OF SCREENING FOR OSTEOMALACIA IN THE ACUTELY ILL ELDERLY

G. A. CAMPBELL, Research Fellow*, D. J. HOSKING, Senior Lecturer In Medicine, J. R. KEMM, Senior Lecturer in Social Medicin and R. V. BOYD, Consultant Physician in Geriatric Medicine

Department of Health Care of the Elderly, Sherwood Hospital Nottingham NG5 1PB
University Hospital, Queen's Medical Centre Nottingham NG7 2UH
Department of Social Medicine, The Medical School, University of Birmingham Edgbaston, Birmingham B15 2TJ
Department of Health Care of the Elderly, Sherwood Hospital

*Present address: Department of Geriatric Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ

Hypocalcaemia and hypophosphataemia either on admission or before discharge from hospital are poor discriminators for the presence of subclinical osteomalacia in the elderly. Reliance has to be placed on the measurement of alkaline phosphatase even though false positive tests are common. Use of paired admission and predischarge data reduces the false positive rate by approximately 50% thereby reducing the requirement for histological confirmation of the diagnosis of osteomalacia. Since the prevalence of osteomalacia is low in this type of hospital population, any measure which reduces the requirement for bone biopsy is of considerable practical value.

accepted in revised form October 24, 1985.


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