Evidence map›Paper›PMID 22762317›Full record

SynthesisThe New England journal of medicine2012

A pooled analysis of vitamin D dose requirements for fracture prevention.

Heike A Bischoff-Ferrari, Walter C Willett, Endel J Orav, Endel J Oray, Paul Lips, Pierre J Meunier, Ronan A Lyons, Leon Flicker, John Wark, Rebecca D Jackson and 7 more

Erratum issuedOpen access · bronzeAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The New England journal of medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 315 papers, 27 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
315citing papers in PubMed, 27 pooled it
70.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

315 citing papers in PubMed, 27 syntheses or guidelines pooled it, 802 citations in OpenAlex.

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  3. The Lebanese GRADE-based vitamin D guidelines: a paradigm for the MENA region.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Guideline
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  17. European guidance for the diagnosis and management of osteoporosis in postmenopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Guideline
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255 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 13 institutions in 7 countries.

Heike A Bischoff-FerrariCenter on Aging and Mobility, University of Zurich and Waid City Hospital, Zurich, Switzerland.
Walter C Willett
Endel J Orav
Endel J Oray
Paul Lips
Pierre J Meunier
Ronan A Lyons
Leon Flicker
John Wark
Rebecca D Jackson
Jane A Cauley
Haakon E Meyer
Michael Pfeifer
Kerrie M Sanders
Hannes B Stähelin
Robert Theiler
Bess Dawson-Hughes
Harvard University · USBarwon Health · AUEMGO Institute for Health and Care Research · NLJean Mayer Human Nutrition Research Center on Aging · USNorwegian Institute of Public Health · NOSwansea University · GBThe Ohio State University · USThe Royal Melbourne Hospital · AUTriemli Hospital · CHUniversité Claude Bernard Lyon 1 · FRUniversity Hospital of Zurich · CHUniversity of Pittsburgh · USUniversity of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction have been inconsistent.

methodsWe pooled participant-level data from 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, as compared with placebo or calcium alone in persons 65 years of age or older. Primary end points were the incidence of hip and any nonvertebral fractures according to Cox regression analyses, with adjustment for age group, sex, type of dwelling, and study. Our primary aim was to compare data from quartiles of actual intake of vitamin D (including each individual participant's adherence to the treatment and supplement use outside the study protocol) in the treatment groups of all trials with data from the control groups.

resultsWe included 31,022 persons (mean age, 76 years; 91% women) with 1111 incident hip fractures and 3770 nonvertebral fractures. Participants who were randomly assigned to receive vitamin D, as compared with those assigned to control groups, had a nonsignificant 10% reduction in the risk of hip fracture (hazard ratio, 0.90; 95% confidence interval [CI], 0.80 to 1.01) and a 7% reduction in the risk of nonvertebral fracture (hazard ratio, 0.93; 95% CI, 0.87 to 0.99). By quartiles of actual intake, reduction in the risk of fracture was shown only at the highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30% reduction in the risk of hip fracture (hazard ratio, 0.70; 95% CI, 0.58 to 0.86) and a 14% reduction in the risk of any nonvertebral fracture (hazard ratio, 0.86; 95% CI, 0.76 to 0.96). Benefits at the highest level of vitamin D intake were fairly consistent across subgroups defined by age group, type of dwelling, baseline 25-hydroxyvitamin D level, and additional calcium intake.

conclusionsHigh-dose vitamin D supplementation (≥800 IU daily) was somewhat favorable in the prevention of hip fracture and any nonvertebral fracture in persons 65 years of age or older. (Funded by the Swiss National Foundations and others.).

Indexed as

AgedAged, 80 and overCalciumCalcium, DietaryDose-Response Relationship, DrugDrug Therapy, CombinationFemaleFractures, BoneHip FracturesHumansIntention to Treat AnalysisMaleRandomized Controlled Trials as TopicRiskVitamin D25-hydroxyvitamin DCalciumCalcium, DietaryVitamin D

Identifiers

PMID22762317
OpenAlexW2149088854

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.