Development and evaluation of a vertebral fracture assessment program using IVA and its integration with mobile DXA.

Currently, it is unusual to combine evaluation for vertebral fracture with measurement of bone mineral density in clinical practice. Using Quantitative Morphometric Vertebral Analysis (Instant Vertebral Assessment [IVA]) in our existing Mobile Dual-Energy X-Ray Absorptiometry (DXA) Program, we implemented a testing procedure that examined 5 different IVA protocols focusing on clinical utility and cost. Using small-scale tests of change (PDSA cycles), data from the preceding cycle drives the development of the next cycle.