Body Composition Analysis Report (BIA/DXA)

Report Title: Body Composition Analysis Report (BIA/DXA)

Modality Performed: [DXA / BIA / DXA and BIA]

Test Date/Time: [Test date and time]

Report Date/Time: [Report date and time]

Patient Name: [Patient full name]

DOB: [Date of birth]

MRN: [Medical record number]

Ordering Clinician: [Name, credentials]

Interpreting Clinician: [Name, credentials]

Facility/Location: [Facility name and location]

Device: [Manufacturer, model, software version]

Clinical Context

(Use one short paragraph or compact bullet list. If indication is not provided, state: "Indication not provided; interpretation limited to descriptive findings.")

• Indication: [Reason for testing]
• Clinical question(s): [Specific question(s) the test should address]
• Relevant background: [Recent illness, fluid-shifting conditions, medications, surgeries, implants, amputations, or other pertinent context]
• Intended use of results: [Treatment planning / monitoring / risk assessment / other]

Method & Quality

• Protocol/analysis mode: [Protocol or analysis mode]
• Reference standard for Z-scores/percentiles: [Reference population or dataset / Not reported]
• Prior studies available for comparison: [Yes / No]
• Technical adequacy: [Adequate / Limited / Nondiagnostic] — [Limiting factors, if any]

DXA-specific: (Include only if DXA performed)

• Scan type: [Total body with head / Total body less head]
• Pregnancy screening documented: [Yes / No / Unknown]
• Cross-calibration status: [Same system / Cross-calibrated / Not cross-calibrated / Not applicable] (Include only if comparing across systems)

BIA-specific: (Include only if BIA performed)

• Configuration: [Single-frequency / Multi-frequency] — [Segmental / Whole-body] — [Standing / Supine]
• Equation/algorithm: [Model or equation identifier]
• Measurement conditions: [Posture, fasting state, hydration status, pre-measurement abstentions]
• Clinical cautions: [Abnormal hydration / Extremes of BMI / Amputations / Implanted devices / Other] (Flag if present; omit if none)

Anthropometrics

Metric	Value	Unit
Height	[Height value]	[cm / in]
Weight	[Weight value]	[kg / lb]
BMI (Derived)	[BMI value]	kg/m²
Waist circumference	[Waist value]	[cm / in]

Measurement source: [Measured / Self-reported / Mixed]

Results

(Use consistent terminology throughout: either "lean mass" or "fat-free mass." Always include units; label calculated metrics as Derived.)

Metric	Value	Unit	Z-score/Percentile	Derived
Total mass	[Value]	kg	[Z-score or percentile, if available]	No
Total [lean mass / fat-free mass]	[Value]	kg	[Z-score or percentile, if available]	No
Total fat mass	[Value]	kg	[Z-score or percentile, if available]	No
Percent fat mass	[Value]	%	[Z-score or percentile, if available]	Yes
BMI	[Value]	kg/m²	[Z-score or percentile, if available]	Yes
Total body BMC	[Value]	g	[Z-score or percentile, if available]	No
Total body BMD	[Value]	g/cm²	[Z-score or percentile, if available]	No

(Include BMC and BMD rows only for DXA)

Optional indices: (Include only if clinically relevant to the indication)

Metric	Value	Unit	Z-score/Percentile	Derived
Visceral adipose tissue (VAT) estimate	[Value]	[cm² / g]	[Z-score or percentile, if available]	[Yes / No]
Appendicular lean mass (ALM)	[Value]	kg	[Z-score or percentile, if available]	No
ALM index (ALM/height²)	[Value]	kg/m²	[Z-score or percentile, if available]	Yes
Lean mass index	[Value]	kg/m²	[Z-score or percentile, if available]	Yes
Fat mass index	[Value]	kg/m²	[Z-score or percentile, if available]	Yes
Android/gynoid fat ratio	[Value]	ratio	[Z-score or percentile, if available]	Yes
Segmental values	[Relevant segmental lean or fat mass values]	[kg / %]	[Z-score or percentile, if available]	[Yes / No]

BIA raw/hydration parameters: (Include only if BIA performed)

Parameter	Value	Unit	Frequency
Resistance (R)	[Value]	ohm	[Hz]
Reactance (Xc)	[Value]	ohm	[Hz]
Phase angle	[Value]	degrees	[Hz]
Total body water	[Value]	L
ECW/ICW ratio (Derived)	[Value]	ratio

Comparison to Prior

(If no prior study is available, state: "No prior body composition studies available for comparison." and omit the table.)

• Prior study: [Date] — [Modality] — [Device/manufacturer/model]
• Comparability: [Same device / Cross-calibrated / Not cross-calibrated / Different conditions] — [Statement on whether differences may affect trend interpretation; reference LSC if available]

Metric	Current	Prior	Absolute change	Percent change	Comment
Total mass (kg)	[Value]	[Value]	[Value]	[Value]	[Significance relative to measurement precision]
Total [lean / fat-free] mass (kg)	[Value]	[Value]	[Value]	[Value]	[Significance relative to measurement precision]
Total fat mass (kg)	[Value]	[Value]	[Value]	[Value]	[Significance relative to measurement precision]
Percent fat mass (%)	[Value]	[Value]	[Value]	[Value]	[Significance relative to measurement precision]
ALM or ALM index	[Value]	[Value]	[Value]	[Value]	[Significance relative to measurement precision]

Interpretation

(Structured narrative. Do not repeat measured values except to support interpretation. Use descriptive language such as "elevated adiposity relative to reference" rather than diagnostic labels. Carry forward technical limitations that materially affect interpretation.)

• Adiposity: [Percent fat and distribution pattern relative to reference; comment on VAT or android/gynoid pattern if assessed]
• Lean mass status: [Whether lean mass indices are low relative to reference. Do NOT diagnose sarcopenia from mass alone; if strength/performance data are missing, explicitly state what is needed for confirmation, e.g., grip strength, gait speed, chair rise]
• Sarcopenic obesity risk: [If both excess adiposity and low lean mass are present, note that the pattern raises concern for sarcopenic obesity risk and specify required functional testing for confirmation] (Include only if applicable)
• Hydration confounding: [If edema, rapid weight change, acute illness, or abnormal ECW/ICW ratio is present, state that lean mass estimates may be distorted and should not be used alone to diagnose low lean mass states] (Include for BIA or when relevant)
• Integration with clinical context: [Tie findings to the stated clinical question(s) and relevance to treatment goals]

Impression

(2–6 concise bullets focusing on clinically actionable findings)

• [Most important finding; if prior available, include change with directionality and significance relative to measurement precision]
• [Whether lean mass is preserved vs reduced during weight change, if applicable]
• [High-risk patterns present, framed appropriately without overdiagnosis]
• [Major limitations affecting interpretation]

Recommendations

(Tailor to clinical question and available context. If insufficient context to make recommendations, state what information is needed.)

• [How results affect today's plan or risk stratification]
• [Nutrition considerations if indicated]
• [Exercise/resistance training considerations if indicated]
• [Referrals if warranted]
• [Follow-up testing interval and modality with rationale; recommend same device/conditions for comparability]

Electronic Signature: [Interpreting clinician name, credentials, date/time]