ArticleJournal of the American Medical Directors Association2010
Is withholding osteoporosis medication after fracture sometimes rational? A comparison of the risk for second fracture versus death.
Article in Journal of the American Medical Directors Association, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: population-based longitudinal study.Age and ageing · 2016Pooled it
- Fracture prevention in patients with cognitive impairment presenting with a hip fracture: secondary analysis of data from the HORIZON Recurrent Fracture Trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Trial
- Multimodal intervention to improve osteoporosis care in home health settings: results from a cluster randomized trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2013Trial
- Drug utilization pattern of romosozumab and other osteoporosis treatments in Japan, 2019-2021.Journal of bone and mineral metabolism · 2024Article
- Artificial intelligence vs. radiologist: accuracy of wrist fracture detection on radiographs.European radiology · 2023Article
- Characteristics Associated With 5-Year Fracture Risk Versus 5-Year Mortality Risk Among Late-Life Men.The journals of gerontology. Series A, Biological sciences and medical sciences · 2023Article
- Distal radius fractures and risk of incident neurocognitive disorders in older adults: a retrospective cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Prevalence, Characteristics, and Associated Risk Factors of Wrist Fractures in Americans Above 50: The Cross-Sectional NHANES Study.Frontiers in endocrinology · 2022Article
- Assessment of Intravertebral Mechanical Strains and Cancellous Bone Texture Under Load Using a Clinically Available Digital Tomosynthesis Modality.Journal of biomechanical engineering · 2021Article
- Estimated Direct Medical Cost of Osteoporosis in Saudi Arabia: A Single-Center Retrospective Cost Analysis.International journal of environmental research and public health · 2021Article
- Economic Burden of Osteoporosis-Related Fractures in the US Medicare Population.The Annals of pharmacotherapy · 2021Article
- Vertebral stiffness measured via tomosynthesis-based digital volume correlation is strongly correlated with reference values from micro-CT-based DVC.Medical engineering & physics · 2020Article
- Importance of Recent Fracture as Predictor of Imminent Fracture Risk.Current osteoporosis reports · 2018Review
- Incidence of subsequent fractures in the UK between 1990 and 2012 among individuals 50 years or older.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Observational
- Consensus statement: osteoporosis prevention and treatment in Latin America-current structure and future directions.Archives of osteoporosis · 2018Review
- Prevalence and Cost of Subsequent Fractures Among U.S. Patients with an Incident Fracture.Journal of managed care & specialty pharmacy · 2017Article
- Anti-Osteoporosis Medication Prescriptions and Incidence of Subsequent Fracture Among Primary Hip Fracture Patients in England and Wales: An Interrupted Time-Series Analysis.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2016Article
- Wrist Fracture and Risk of Subsequent Fracture: Findings from the Women's Health Initiative Study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2015Article
- The risk of major and any (non-hip) fragility fracture after hip fracture in the United Kingdom: 2000-2010.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Article
- Death, debility, and destitution following hip fracture.The journals of gerontology. Series A, Biological sciences and medical sciences · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
introductionUndertreatment of osteoporosis is common, even for high-risk patients. Among the reasons for undertreatment may be a clinician's perception of a lack of treatment benefit, particularly in light of patients' expected future mortality. Among US Medicare beneficiaries, we evaluated the risk for second fracture versus death in the 5 years following a hip, clinical vertebral, and wrist/forearm fracture.
methodsUsing data from 1999 to 2006 for a random 5% sample of US Medicare beneficiaries, we identified individuals who experienced an incident hip, clinical vertebral, or wrist/forearm fracture in 2000 or 2001. We evaluated the risk for a second incident fracture versus death in the following 5 years. Results were stratified by age, gender, race/ethnicity, and medical comorbidities. In light of the competing mortality risk, and assuming 30% efficacy of an osteoporosis medication to prevent a second fracture, we calculated the number of individuals needed to treat (NNT) for 5 years after first fracture to prevent 1 additional subsequent fracture.
resultsWe identified 18,853, 12,751, and 7635 persons with an incident hip, clinical vertebral, and wrist/forearm fracture, respectively. Although the 5-year risk of death usually exceeded the risk for second fracture across age, gender, racial groups, and primary fracture type (median ratio of death to second fracture=1.4, interquartile range 0.9, 2.0), the 5-year risk for second fracture was high, varying from a low of 13% to a high of 43%. Across demographic groups, the NNT to prevent a second fracture was low, ranging from 8 to 46.
conclusionAmong older persons with hip, clinical vertebral, or wrist/forearm fracture, although the risk for death was usually greater than the risk for a second fracture, both were high. The relatively low NNT to prevent 1 additional subsequent fracture fell within a range generally considered acceptable for secondary prevention strategies.
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