Another direction for further research will be to test whether the combination of BMD and texture analysis both from a portable instrument could be used to monitor therapy, particularly in a primary care setting or in long-term care institutions. To test this, we will conduct studies which will compare the outcomes and cost-effectiveness of approach where decisions regarding treatment changes are based on BMD and texture analysis from a portable instrument and the conventional approach based on periodic monitoring by central densitometry with or without use of the biochemical markers of bone turnover.