Evidence map›Paper›PMID 22836812›Full record

Trial reportJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2012

A randomized trial of a mailed intervention and self-scheduling to improve osteoporosis screening in postmenopausal women.

Amy H Warriner, Ryan C Outman, Elizabeth Kitchin, Lang Chen, Sarah Morgan, Kenneth G Saag, Jeffrey R Curtis

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
1.5field-weighted citation impact, top 20% 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

9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Interventions to improve osteoporosis care: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Pooled it
  2. How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018
    Pooled it
  3. Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018
    Pooled it
  4. Evaluation of a Multimodal, Direct-to-Patient Educational Intervention Targeting Barriers to Osteoporosis Care: A Randomized Clinical Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018
    Trial
  5. Trial
  6. Comparison of interactive voice response, patient mailing, and mailed registry to encourage screening for osteoporosis: a randomized controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014
    Trial
  7. Notable lacking of bone mineral density measurement in cushing syndrome: a nationwide study based on the US insurance claim database.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
  8. Physician-Reported Barriers to Osteoporosis Screening: A Nationwide Survey.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2023
    Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Amy H WarrinerDivision of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Ryan C Outman
Elizabeth Kitchin
Lang Chen
Sarah Morgan
Kenneth G Saag
Jeffrey R Curtis
University of Alabama at Birmingham · US

Funding

UAB K 12 In Comparative Effectiveness ResearchK12HS019465 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2010 to 2010
$2.1M
Mid-Career Investigator Award (for Kenneth G. Saag, MD, MSc)K24AR052361 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2005 to 2014
$1.7M
Ethnic Differences in the Risk of Fracture and Vascular DiseaseK23AR053351 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CURTIS, JEFFREY R. · 2007 to 2011
$755k
AHRQ HHS K12 HS019465NIAMS NIH HHS AR053351NIAMS NIH HHS K23 AR053351NIAMS NIH HHS K24 AR052361
6 · The paper itself

Abstract

Guidelines recommend bone density screening with dual-energy X-ray absorptiometry (DXA) in women 65 years or older, but <30% of eligible women undergo DXA testing. There is a need to identify a systematic, effective, and generalizable way to improve osteoporosis screening. A group randomized, controlled trial of women ≥65 years old with no DXA in the past 4 years, randomized to receive intervention materials (patient osteoporosis brochure and a letter explaining how to self-schedule a DXA scan) versus usual care (control) was undertaken. Outcome of interest was DXA completion. Of 2997 women meeting inclusion criteria, 977 were randomized to the intervention group. A total of 17.3% of women in the intervention group completed a DXA, compared to 5.2% in the control group (12.1% difference, p < 0.0001). When including only those medically appropriate, we found a difference of 19% between the two groups (p < 0.0001). DXA receipt was greater in main clinic patients compared to satellite clinic patients (20.9% main clinic versus 10.1% satellite clinic). The cost to print and mail the intervention was $0.79 per patient, per mailing. The number of women to whom intervention needed to be mailed to yield one extra DXA performed was 9, at a cost of $7.11. DXA scan completion was significantly improved through use of a mailed osteoporosis brochure and the availability for patients to self-schedule. This simple approach may be an effective component of a multifaceted quality improvement program to increase rates of osteoporosis screening.

Indexed as

Appointments and SchedulesMass ScreeningPostal ServiceAbsorptiometry, PhotonAcademic Medical CentersAgedAged, 80 and overAlabamaFemaleHumansOsteoporosis, PostmenopausalPatient Education as Topic

Identifiers

PMID22836812
PMCPMC3502704
OpenAlexW2057683629

What OpenQuestion holds

Textmetadata
LicenceTDM
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.