Evidence map›Paper›PMID 29429033›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

Implementing a fracture liaison service open model of care utilizing a cloud-based tool.

S L Greenspan, A Singer, K Vujevich, B Marchand, D A Thompson, Y-J Hsu, D Vaidya, L S Stern, D Zeldow, D B Lee and 2 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

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 8 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 pooled it
1.2field-weighted citation impact, top 25% 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

8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  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. Pooled it
  3. Implementation and operationalization of Integrated People-Centred Health Services delivery strategies in integrated osteoporosis care (IOC) initiatives: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Pooled it
  4. Pooled it
  5. Article
  6. The clinician's guide to prevention and treatment of osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Article
  7. Article
  8. How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    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

12 authors at 6 institutions in 1 country.

S L GreenspanDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. GREENSPN@PITT.EDU.
A SingerDepartment of Obstetrics and Gynecology and Medicine, MedStar Georgetown University Hospital, Washington, DC, USA.
K VujevichDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
B MarchandCECity®, a subsidiary of Premier, Inc., Pittsburgh, PA, USA.
D A ThompsonJohns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.
Y-J HsuJohns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.
D VaidyaJohns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.
L S SternMerck Research Labs, Merck & Co., North Wales, PA, USA.
D ZeldowNational Bone Health Alliance, Arlington, VA, USA.
D B LeeNational Bone Health Alliance, Arlington, VA, USA.
S KarpCECity®, a subsidiary of Premier, Inc., Pittsburgh, PA, USA.
R ReckerDepartment of Medicine, Creighton University Hospital, Omaha, NE, USA.
National Patient Safety Foundation · USPremier Research Group · USUniversity of Pittsburgh · USCreighton University · USMedStar Georgetown University Hospital · USMerck & Co., Inc., Rahway, NJ, USA (United States) · US

Funding

VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JENNIFER S BRACH · 2004 to 2026
$28.6M
NIA NIH HHS P30 AG024827
6 · The paper itself

Abstract

purposeAlthough half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool.

methodsThe pre-post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool.

resultsNinety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS.

conclusionsWe conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.

Indexed as

Models, OrganizationalAbsorptiometry, PhotonAgedBone DensityBone Density Conservation AgentsCalciumCloud ComputingDelivery of Health Care, IntegratedDietary SupplementsDrug UtilizationFemaleHumansMaleMiddle AgedOsteoporosisOsteoporotic FracturesBone Density Conservation AgentsCalciumVitamin DBone mineral densityCalciumFractureFracture Liaison ServiceOsteoporosisVitamin D

Identifiers

PMID29429033
PMCPMC6481927
OpenAlexW2787192169

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.