Trial reportMedical care2014
Effect of self-referral on bone mineral density testing and osteoporosis treatment.
Trial report in Medical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled 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.
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
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- 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 · 2020Pooled it
- 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 · 2018Pooled it
- 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 · 2018Pooled it
- Correlations Between Abnormal Glucose Metabolism and Bone Mineral Density or Bone Metabolism.Medical science monitor : international medical journal of experimental and clinical research · 2016Pooled it
- 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 · 2018Trial
- Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN 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 · 2016Trial
- 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 · 2025Article
- Geographical variation in osteoporosis in Australian women: a longitudinal analysis over 23 years.Archives of osteoporosis · 2024Article
- An Emergency Department-based system intervention to improve osteoporosis screening for older adults at high-risk of fracture.JBMR plus · 2024Article
- Engagement in Primary Prevention Program among Rural Veterans With Osteoporosis Risk.JBMR plus · 2022Article
- Delivering fracture prevention services to rural US veterans through telemedicine: a process evaluation.Archives of osteoporosis · 2021Article
- Institutional strategies as a mechanism to rationalize the negative effects of the judicialization of access to medicine in Brazil.BMC health services research · 2020Article
- Quality Measures and Quality Improvement Initiatives in Osteoporosis-an Update.Current osteoporosis reports · 2019Review
- Population-Based Osteoporosis Primary Prevention and Screening for Quality of Care in Osteoporosis, Current Osteoporosis Reports.Current osteoporosis reports · 2019Review
- Fracture Prediction by Computed Tomography and Finite Element Analysis: Current and Future Perspectives.Current osteoporosis reports · 2018Review
- A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material.Contemporary clinical trials communications · 2016Article
- Quantitative computed tomography and opportunistic bone density screening by dual use of computed tomography scans.Journal of orthopaedic translation · 2015Review
- Proceedings of the 2015 Santa Fe Bone Symposium: Clinical Applications of Scientific Advances in Osteoporosis and Metabolic Bone Disease.Journal of clinical densitometry : the official journal of the International Society for Clinical DensitometryArticle
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 5 institutions in 2 countries.
Funding
Abstract
backgroundDespite national guidelines recommending bone mineral density screening with dual-energy x-ray absorptiometry (DXA) in women aged 65 years and older, many women do not receive initial screening.
objectiveTo determine the effectiveness of health system and patient-level interventions designed to increase appropriate DXA testing and osteoporosis treatment through (1) an invitation to self-refer for DXA (self-referral); (2) self-referral plus patient educational materials; and (3) usual care (UC, physician referral). RESEARCH
designParallel, group-randomized, controlled trials performed at Kaiser Permanente Northwest (KPNW) and Kaiser Permanente Georgia (KPG). SUBJECTS: Women aged 65 years and older without a DXA in past 5 years. MEASURES: DXA completion rates 90 days after intervention mailing and osteoporosis medication receipt 180 days after initial intervention mailing.
resultsFrom >12,000 eligible women, those randomized to self-referral were significantly more likely to receive a DXA than UC (13.0%-24.1% self-referral vs. 4.9%-5.9% UC, P<0.05). DXA rates did not significantly increase with patient educational materials. Osteoporosis was detected in a greater proportion of self-referral women compared with UC (P<0.001). The number needed to receive an invitation to result in a DXA in KPNW and KPG regions was approximately 5 and 12, respectively. New osteoporosis prescription rates were low (0.8%-3.4%) but significantly greater among self-referral versus UC in KPNW.
conclusionsDXA rates significantly improved with a mailed invitation to schedule a scan without physician referral. Providing women the opportunity to self-refer may be an effective, low-cost strategy to increase access for recommended osteoporosis screening.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.