Pisu M, Kopperdahl DL, Lewis CE, et al. - in the US Medicare population aged 65 years and older, the rates are low for osteoporosis screening by DXA (9.5% women, 1.7% men), so researchers assessed the advantages of a validated osteoporosis diagnostic test for patients 65 years of age and older with an abdominal computed tomography (CT) scan taken for any indication but without a recent DXA. A hypothetical cohort of 1,000 such patients in a given year was assessed and followed for 5 years. The authors discovered that biomechanical computed tomography (BCT) offered greater clinical advantage for both sexes at a reduced cost vs usual care. Preventive hip fractures vs usual care stayed high (2.7 per 1,000 females; 1.5 per 1,000 males) when BCT's sensitivity and specificity were set for DXA, suggesting how higher screening rates impact clinical efficacy. Compared to current usual care, osteoporosis screening using biomechanical computed tomography can be a cost-effective alternative for patients who already had an abdominal CT and without a recent DXA.