Evidence map›Paper›PMID 29063214›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

Geisinger high-risk osteoporosis clinic (HiROC): 2013-2015 FLS performance analysis.

P Dunn, D Webb, T P Olenginski

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
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6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: 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 · 2024
    Pooled it
  2. Clinical impact of acute symptomatic vertebral fractures in the United States: A patient survey and chart review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Observational
  3. Article
  4. Fracture liaison service evaluation during admission for fragility femur fracture increases rates of bone health intervention and outpatient follow-up.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
  5. A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
  6. 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

3 authors.

P DunnGeisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA. pdunn1@geisinger.edu.ORCID http://orcid.org/0000-0003-3100-607X
D WebbGeisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA.
T P OlenginskiGeisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Geisinger Health System (GHS) high-risk osteoporosis clinic (HiROC), which treats patients with low-trauma, fragility fractures, reports their 2013-2015 performance measures in secondary fracture prevention. This fracture liaison service (FLS) pathway treats 75% of high-risk, drug eligible patients, compared to 13.8% in GHS primary care. This performance points to the need for more FLS programs throughout the world.

introductionThe purpose of this study is to analyze and report ongoing performance measures in outpatient and inpatient high-risk osteoporosis clinic (HiROC) program designed for patients with low-trauma, fragility fractures.

methodsRetrospective chart review of outpatient HiROC (511 patients) and inpatient HiROC (1279 patients) performance from 2013 to 2015 is reported within Geisinger Health System (GHS).

resultsSimilar to a prior report, we document that Geisinger's branded outpatient and inpatient HiROC pathways continue to function as an all-fracture FLS. Importantly, this analysis emphasizes the importance of FLS care that HiROC's treatment rate of 75% was markedly superior to GHS-PCP care of 13.8%. However, a large percentage of patients (37.8%) were lost to follow-up care. This led to the identification of multiple care gaps/barriers to ideal best practice.

conclusionsFLS programs use case finding strategies and address secondary fracture prevention. GHS HiROC's performance and initiation of drug therapy in this fracture patient population contrasts with GHS-PCP care's much lower rate of treatment, documenting the need for ongoing FLS care. Importantly, the results of this analysis have prompted the beginnings of GHS programmatic changes, designed to narrow the reported care gaps in this mature FLS.

Indexed as

Absorptiometry, PhotonAdultAgedAged, 80 and overAmbulatory Care FacilitiesBone Density Conservation AgentsCritical PathwaysFemaleHealth Services ResearchHospitalizationHumansMaleMiddle AgedOsteoporosisOsteoporotic FracturesPennsylvaniaBone Density Conservation AgentsCare gapsFLSHiROCOsteoporosisQuality improvement

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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.